Chronisch rekurrierende multifokale Osteomyelitis

Zusammenfassung

Die chronisch rekurrierende multifokale Osteomyelitis (CRMO) ist eine gutartige autoinflammatorische Erkrankung des Knochengewebes im Kindesalter mit noch ungeklärter Ätiologie. Bei 32 Kindern im Alter von 1,5 bis 15 Jahren wurde an unserer Klinik zwischen November 2006 und Dezember 2013 eine CRMO diagnostiziert. Insgesamt wurden in der gesamten Patientenkohorte 114 Knochenläsionen dokumentiert, bis zu 12 betroffene Knochen pro Patient. Mit jeweils 34 % der Patienten waren Becken und Klavikula die am häufigsten betroffenen Knochen. Das Fußskelett war mit 60 % die meist betroffene Skelettregion. Hautbeteiligungen, wie eine palmoplantare Pustulose oder eine Akne, zeigten sich bei 7 (21 %) Kindern. Erhöhte Entzündungszeichen bei Erstvorstellung waren in 18 Fällen (56 %) nachweisbar. Die Magnetresonanztomografie und Knochenbiopsien erwiesen sich als sensitive Methoden zur Bestätigung der Diagnose einer chronischen rekurrierenden multifokalen Osteomyelitis. Als Initialtherapie wurden bei 88 % der Patienten nichtsteroidale Antirheumatika verwendet. In 70 % wurde alleine hierdurch eine komplette Remission erzielt.

Summary

The chronic recurrent multifocal osteomyelitis (CRMO) is a benign autoinflammatory disease of the bone in childhood with still not completely claryfied etiology. Overall 32 children aged from 1.5 to 15 years were diagnosed with CRMO at our clinic between November 2006 and December 2013. We documented 114 different CRMO-spots with a maximum of 12 affected bones in a single patient. Pelvis and clavicle are the most common affected single bones involved in 34 % of patients each. The foot skeleton was the most commonly affected region with 60 % of patients. Skin manifestations like palmoplantar pustulosis or acne were found in 7 (21 %) children. Increased laboratory inflammation markers were found in 18 patients (56 %). Magnetic resonance imaging and biopsy were both sensitive for confirming the diagnosis of a CRMO. For initial treatment, nonsteroidal anti-inflammatory drugs were used in 88 % of patients. A remission without further treatment could be achieved in 70 % of patients.

Schlüsselwörter

Chronisch rekurrierende multifokale Osteomyelitis (CRMO) - chronische nicht bakterielle Osteitis (CNO) - chronische Knochenerkrankung

Keywords

Chronic recurrent multifocal osteomyelitis (CRMO) - chronic non-bacterial osteitis (CNO) - chronic bone disease

• Literatur

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