Experience of successful treatment of a patient with chronic non-bacterial osteomyelitis (clinical case)

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BACKGROUND: Chronic nonbacterial osteomyelitis is a rare autoinflammatory bone disease with periods of relapses and remissions. No etiotropic therapy, diagnostic and treatment standards exist, patients are observed by rheumatologists, immunologists, and orthopedist. They receive symptomatic, anti-inflammatory treatment, broad-spectrum antibiotics, immunosuppressants to control inflammation, which helps to prevent new or to reduce existing pathological foci.

CLINICAL CASE DESCRIPTION: This article describes the effect of immune therapy and osteotropic treatment with zoledronic acid combination in a patient with chronic non-bacterial osteomyelitis. In a clinical observation involving comprehensive examination, including radiological (radiography, computed tomography and magnetic resonance imaging) and laboratory methods, a positive outcome was achieved using conservative methods of treatment in a patient with chronic non-bacterial sternum osteomyelitis.

CONCLUSION: Thus, a combination of bisphosphonates and immunotherapy may be promising in the treatment of chronic non-bacterial osteomyelitis. However, it is unknown as to how long the remission will last and what treatment program is necessary for the final disease resolution.

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作者简介

Gazinur Tairov

Priorov National Medical Research Center of Traumatology and Orthopedics

编辑信件的主要联系方式.
Email: Gazinur.vezunchik@mail.ru

Post-Graduate Student, Traumatologist-Orthopedist

俄罗斯联邦, Moscow

Anna Toptygina

G.N. Gabrichevsky Research Institute for Epidemiology and Microbiology

Email: toptyginaanna@rambler.ru
ORCID iD: 0000-0002-9981-4762
SPIN 代码: 8523-5018

MD, Dr. Sci. (Med.), Immunologist-Allergologist, Head of the Laboratory of Cytokines

俄罗斯联邦, Moscow

Alexander Ochkurenko

Priorov National Medical Research Center of Traumatology and Orthopedics

Email: cito-omo@mail.ru
ORCID iD: 0000-0002-1078-9725
SPIN 代码: 8324-2383

MD, Dr. Sci. (Med.), Professor, Traumatologist-Orthopedist

俄罗斯联邦, Moscow

Yuriy Buklemishev

Priorov National Medical Research Center of Traumatology and Orthopedics

Email: buklemishev@mail.ru
ORCID iD: 0000-0002-0039-2118
SPIN 代码: 4329-4720

MD, Traumatologist-Orthopedist

俄罗斯联邦, Moscow

Igor Karpov

Priorov National Medical Research Center of Traumatology and Orthopedics

Email: igoukarpoff@mail.ru
ORCID iD: 0000-0002-3135-9361
SPIN 代码: 5943-3689

MD, Cand. Sci. (Med.), Radiologist

俄罗斯联邦, Moscow

参考

  1. Zhao DY, McCann L, Hahn G, Hedrich CM. Chronic nonbacterial osteomyelitis (CNO) and chronic recurrent multifocal osteomyelitis (CRMO). J Transl Autoimmun. 2021;4:100095. doi: 10.1016/j.jtauto.2021.100095
  2. Buch K, Thuesen ACB, Brøns C, Schwarz P. Chronic Non-bacterial Osteomyelitis: A Review. Calcif Tissue Int. 2019;104(5):544–553. doi: 10.1007/s00223-018-0495-0
  3. Girschick H, Finetti M, Orlando F, et al. The multifaceted presentation of chronic recurrent multifocal osteomyelitis: a series of 486 cases from the Eurofever international registry Rheumatology (Oxford). 2018;57(7):1203–1211. doi: 10.1093/rheumatology/key058
  4. Ferguson PJ, Sandu M. Current understanding of the pathogenesis and management of chronic recurrent multifocal osteomyelitis. Curr Rheumatol Rep. 2012;14(2):130–141. doi: 10.1007/s11926-012-0239-5
  5. Hedrich CM, Hofmann SR, Pablik J, et al. Autoinflammatory bone disorders with special focus on chronic recurrent multifocal osteomyelitis (CRMO). Pediatr Rheumatol Online J. 2013;11(1):47. doi: 10.1186/1546-0096-11-47
  6. Hofmann SR, Schnabel A, Rösen-Wolff A, et al. Chronic Nonbacterial Osteomyelitis: Pathophysiological Concepts and Current Treatment Strategies. J Rheumatol. 2016;43(11):1956–1964. doi: 10.3899/jrheum.160256
  7. 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
  8. Berezhnyi AP, Ochkurenko AA. Conservative treatment of chronic recurrent multifocal osteomyelitis in children. N.N. Priorov Journal of Traumatology and Orthopedics. 1998;5(1):37–43. (In Russ). doi: 10.17816/vto104392
  9. Ochkurenko AA. On the issue of the effectiveness of hormonal and nonsteroidal anti-inflammatory therapy in the treatment of chronic recurrent multifocal osteomyelitis. Proceedings of the scientific session of the Russian Academy of Postgraduate Education dedicated to the 850th anniversary of Moscow. Issue 2. Moscow, 1997. P. 171–172. (In Russ).
  10. Petukhova V, Mushkin A, Kostik M. Bisphosphonate treatment in the bone disorders in children: a systematic review. Medical alliance. 2021:9(3):59–70. (In Russ). doi: 10.36422/23076348-2021-9-3-59-70
  11. Miettunen PM, Wei X, Kaura D, et al. Dramatic pain relief and resolution of bone inflammation following pamidronate in 9 pediatric patients with persistent chronic recurrent multifocal osteomyelitis (CRMO). Pediatr Rheumatol Online J. 2009;7:2. doi: 10.1186/1546-0096-7-2
  12. Morbach H, Stenzel M, Girschick HJ. Bisphosphonate treatment for patients with chronic nonbacterial osteomyelitis. Nat Clin Pract Rheumatol. 2008;4(11):570–571. doi: 10.1038/ncprheum0908
  13. Yamashita K, Calderaro C, Labianca L, et al. Chronic recurrent multifocal osteomyelitis (CRMO) involving spine: A case report and literature review. J Orthop Sci. 2021;26(2):300–305. doi: 10.1016/j.jos.2018.06.015
  14. Zhao Y, Chauvin NA, Jaramillo D, Burnham JM. Aggressive Therapy Reduces Disease Activity without Skeletal Damage Progression in Chronic Nonbacterial Osteomyelitis. J Rheumatol. 2015;42(7):1245–1251. doi: 10.3899/jrheum.141138
  15. Hofmann C, Wurm M, Schwarz T, et al. A standardized clinical and radiological follow-up of patients with chronic non-bacterial osteomyelitis treated with pamidronate. Clin Exp Rheumatol. 2014;32(4):604–609.
  16. Tsiskarashvili AV, Rodionova SS, Mironov SP, et al. Dynamics of bone tissue metabolism in the complex treatment of chronic posttraumatic osteomyelitis of long bones. N.N. Priorov Journal of Traumatology and Orthopedics. 2020;27(4):53–64. (In Russ). doi: 10.17816/vto52895
  17. Hedrich CM, Morbach H, Reiser C, Girschick HJ. 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
  18. Hofmann SR, Kapplusch F, Mäbert K, Hedrich CM. The molecular pathophysiology of chronic non-bacterial osteomyelitis (CNO)-a systematic review. Mol Cell Pediatr. 2017;4(1):7. doi: 10.1186/s40348-017-0073-y
  19. 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

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2. Fig. 1. Multi-spectral computed tomography picture of the sternum from 07.04.2020. Sagittal partition, 0.625 mm, multiplanar reconstruction.

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3. Fig. 2. Magnetic resonance imaging before use of zolendronic acid. PD/FS, coronal (a) and sagittal (b) partitions.

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4. Fig. 3. Magnetic resonance imaging after therapy of zoledronic acid. PD/FS, coronal (a) and sagittal (b) partitions. Positive dynamics in the area of the affected sternum.

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