椎体和额骨的非细菌性骨髓炎:一例罕见临床病例报告和文献综述
- 作者: Kozhevnikov A.N.1, Zorin V.I.2
-
隶属关系:
- H. Turner National Medical Research Center for Children's Orthopedics and Trauma Surgery
- H. Turner National Medical Research Center for Children’s Orthopedics and Trauma Surgery
- 期: 卷 11, 编号 4 (2023)
- 页面: 517-527
- 栏目: Clinical cases
- URL: https://journals.rcsi.science/turner/article/view/251910
- DOI: https://doi.org/10.17816/PTORS529686
- ID: 251910
如何引用文章
详细
论证。非细菌性骨髓炎是一种病因不明的慢性免疫炎症性疾病,以“无菌”骨破坏灶为特征,通常在儿童时期发病。椎体受累是非细菌性骨髓炎的常见表现,但除下颌骨外,面颅骨受累的情况极为罕见。
临床观察。文章介绍了一例诊治11岁儿童胸椎体和额骨多灶性病变导致发展为破坏性额叶炎的临床病例。根据活检结果,确定了非细菌性骨髓炎的诊断;排除了感染过程、肿瘤和破坏灶的特殊成因。治疗使用了伊班膦酸。第一次输注药物后,临床症状有所改善。第四次输注后,炎症消退,额骨结构和胸椎体恢复了完整性。
讨论。众所周知,在非甾体抗炎药物治疗无效的情况下,双膦酸盐可用于治疗儿童非细菌性骨髓炎。根据一些数据显示,双膦酸盐治疗的有效率达到75%。然而,在非细菌性骨髓炎中使用双膦酸盐的算法尚未制定。文章分析了罕见的非细菌性骨髓炎的文献数据,并介绍了双膦酸盐疗法的选择问题。
结论。非细菌性骨髓炎是一种可能治愈的疾病,其治疗的成功取决于转诊到风湿病科的时间。
作者简介
Aleksei N. Kozhevnikov
H. Turner National Medical Research Center for Children's Orthopedics and Trauma Surgery
编辑信件的主要联系方式.
Email: infant_doc@mail.ru
ORCID iD: 0000-0003-0509-6198
SPIN 代码: 1230-6803
MD, PhD, Cand. Sci. (Med.), Pediatric Rheumatologist
俄罗斯联邦, Saint PetersburgVyacheslav I. Zorin
H. Turner National Medical Research Center for Children’s Orthopedics and Trauma Surgery
Email: zoringlu@yandex.ru
ORCID iD: 0000-0002-9712-5509
SPIN 代码: 4651-8232
MD, PhD, Cand. Sci. (Med.), Assistant Professor
俄罗斯联邦, Saint Petersburg参考
- Kostik MM, Maletin AS, Petukhova VV, et al. Nonbacterial and bacterial osteomyelitis in children: a case-control retrospective study. Front Pediatr. 2023;11. doi: 10.3389/fped.2023.1067206
- Roderick MR, Sen ES, Ramanan AV. Chronic recurrent multifocal osteomyelitis in children and adults: current understanding and areas for development. Rheumatology (Oxford). 2018;57(1):41–48. doi: 10.1093/rheumatology/kex066
- Chichko AM, Bashlakova AN, Begun AN, et al. Slozhnosti diagnostiki khronicheskogo nebakterial’nogo osteomielita u detei. Meditsinskii zhurnal. 2022;4(82):126–132. (In Russ.)
- Grote V, Silier CC, Voit AM, et al. Bacterial osteomyelitis or nonbacterial osteitis in children: a study involving the German surveillance unit for rare diseases in childhood. Pediatr Infect Dis J. 2017;36(5):451–456. doi: 10.1097/INF.0000000000001469
- Schnabel A, Range U, Hahn G, et al. Unexpectedly high incidences of chronic non-bacterial as compared to bacterial osteomyelitis in children. Rheumatol Int. 2016;36(12):1737–1745. doi: 10.1007/s00296-016-3572-6
- Hofmann SR, Kapplusch F, Girschick HJ, et al. Chronic recurrent multifocal osteomyelitis (crmo): presentation, pathogenesis, and treatment. Curr Osteoporos Rep. 2017;15(6):542–554. doi: 10.1007/s11914-017-0405-9
- Hedrich CM, Morbach H, Reiser C, et al. New insights into adult and paediatric chronic non-bacterial osteomyelitis CNO. Curr Rheumatol Rep. 2020;22(9):52. doi: 10.1007/s11926-020-00928-1
- Koryllou A, Mejbri M, Theodoropoulou K, et al. Chronic nonbacterial osteomyelitis in children. Children (Basel). 2021;8(7):551. doi: 10.3390/children8070551
- Iyer RS, Thapa MM, Chew FS. Chronic recurrent multifocal osteomyelitis: review. Am J Roentgenol. 2011;196(6):87–91. doi: 10.2214/AJR.09.7212
- Ma L, Liu H, Tang H, et al. Clinical characteristics and outcomes of chronic nonbacterial osteomyelitis in children: a multicenter case series. Pediatr Rheumatol Online J. 2022;20(1):1. doi: 10.1186/s12969-021-00657-4
- Schaal MC, Gendler L, Ammann B, et al. Imaging in non-bacterial osteomyelitis in children and adolescents: diagnosis, differential diagnosis and follow-up-an educational review based on a literature survey and own clinical experiences. Insights Imaging. 2021;12(1):113. doi: 10.1186/s13244-021-01059-6
- Dhanrajani A, Khubchandani RP. Bisphosphonates in pediatric rheumatology: a review. Int J Clin Rheumatol. 2018;13(3):179–184.
- Bhat CS, Anderson C, Harbinson A, et al. Chronic non-bacterial osteitis – a multicentre study. Pediatr Rheumatol Online J. 2018;16(1):74. doi: 10.1186/s12969-018-0290-5
- Wipff J, Costantino F, Lemelle I, et al. A large national cohort of French patients with chronic recurrent multifocal osteitis. Arthritis Rheumatol. 2015;67(4):1128–1137. doi: 10.1002/art.39013
- Hofmann SR, Kubasch AS, Range U, et al. Serum biomarkers for the diagnosis and monitoring of chronic recurrent multifocal osteomyelitis (CRMO). Rheumatol Int. 2016;36(6):769–779. doi: 10.1007/s00296-016-3466-7
- Kozlova AL, Burlakov VI, Nesterenko ZA, et al. Chronic nonbacterial osteomyelitis: single center experience. Pediatric Hematology/Oncology and Immunopathology. 2020;19(4):76–84. (In Russ.) doi: 10.24287/1726-1708-2020-19-4suppl-76-84
- Jansson A, Renner ED, Ramser J, et al. Classification of non-bacterial osteitis: retrospective study of clinical, immunological and genetic aspects in 89 patients. Rheumatology. 2007;46(1):154–160. doi: 10.1093/rheumatology/kel190
- Mudri J, Lock J, Phadke O, et al. Chronic recurrent multifocal osteomyelitis causing optic neuropathy. J AAPOS. 2022;26(1):43–46. doi: 10.1016/j.jaapos.2021.09.003
- Fraleigh R, Wei XC, Yu W, et al. Chronic recurrent multifocal osteomyelitis with a comprehensive approach to differential diagnosis of paediatric skull pain. BMJ Case Rep. 2023;16(1). doi: 10.1136/bcr-2022-252471
- Kofoed MS, Fisker N, Christensen AE, et al. Sinogenic intracranial complications: is adalimumab a culprit? BMJ Case Rep. 2018;2018. doi: 10.1136/bcr-2017-221449.
- Watanabe T, Ono H, Morimoto Y, et al. Skull involvement in a pediatric case of chronic recurrent multifocal osteomyelitis. Nagoya J Med Sci. 2015;77(3):493–500.
- Anderson CM, Irwin G, Martin N. Chronic non-infectiveo osteitis (CNO) presenting as a lytic skull lesion. Rheumatology. 2018;57(8). doi: 10.1093/rheumatology/key273.010
- Roderick MR, Shah R, Rogers V, et al. Chronic recurrent multifocal osteomyelitis (CRMO) – advancing the diagnosis. Pediatr Rheumatol Online J. 2016;14(1):47. doi: 10.1186/s12969-016-0109-1
- Kostik MM, Kopchak OL, Taschilkin AI, et al. Criteria for differentiation of non-bacterial and haematogenous osteomyelitis: a case-control study with prospective verification of the outcomes. Current Pediatrics. 2018;17(6):458–464. (In Russ.) doi: 10.15690/vsp.v17i6.1976
- Zhao Y, Ferguson PJ. Chronic nonbacterial osteomyelitis and chronic recurrent multifocal osteomyelitis in children. Pediatr Clin North Am. 2018;65(4):783–800. doi: 10.1016/j.pcl.2018.04.003
- Kraus R, Laxer RM. Characteristics, treatment options, and outcomes of chronic non-bacterial osteomyelitis in children. Curr Treat Options in Rheum. 2020;6:205–222. doi: 10.1007/s40674-020-00149-8
- Hospach T, Langendoerfer M, von Kalle T, et al. Spinal involvement in chronic recurrent multifocal osteomyelitis (CRMO) in childhood and effect of pamidronate. Eur J Pediatr. 2010;169(9):1105–1111. doi: 10.1007/s00431-010-1188-5
- Shi X, Hou X, Hua H, et al. Case report: Child chronic nonbacterial osteomyelitis with rapid progressive scoliosis-an association with disease? Front Pediatr. 2023;11. doi: 10.3389/fped.2023.1076443
- Hirano D, Chiba K, Yamada S, Ida H. Oral alendronate in pediatric chronic recurrent multifocal osteomyelitis. Pediatr Int. 2017;59(4):506–508. doi: 10.1111/ped.13236
- Kaut S, van den Wyngaert I, Christiaens D, et al. Chronic nonbacterial osteomyelitis in children: a multicentre Belgian cohort of 30 children. Pediatr Rheumatol Online J. 2022;20(1):41. doi: 10.1186/s12969-022-00698-3
- Zhao Y, Wu EY, Oliver MS, et al. Chronic nonbacterial osteomyelitis/chronic recurrent multifocal osteomyelitis study group and the childhood arthritis and rheumatology research alliance scleroderma, vasculitis, autoinflammatory and rare diseases subcommittee. Consensus treatment plans for chronic nonbacterial osteomyelitis refractory to nonsteroidal antiinflammatory drugs and/or with active spinal lesions. Arthritis Care Res (Hoboken). 2018;70(8):1228–1237. doi: 10.1002/acr.23462
- Otto S, Troeltzsch M, Burian E, et al. Ibandronate treatment of diffuse sclerosing osteomyelitis of the mandible: pain relief and insight into pathogenesis. J Craniomaxillofac Surg. 2015;43(9):1837–1842. doi: 10.1016/j.jcms.2015.08.028