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Oral alendronate in pediatric chronic recurrent multifocal osteomyelitis
Author(s) -
Hirano Daishi,
Chiba Kosuke,
Yamada Saya,
Ida Hiroyuki
Publication year - 2017
Publication title -
pediatrics international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.49
H-Index - 63
eISSN - 1442-200X
pISSN - 1328-8067
DOI - 10.1111/ped.13236
Subject(s) - medicine , chronic recurrent multifocal osteomyelitis , osteomyelitis , methotrexate , bisphosphonate , osteitis , first line , pediatrics , bone remodeling , bone pain , antibiotics , surgery , osteoporosis , microbiology and biotechnology , biology
Chronic recurrent multifocal osteomyelitis ( CRMO ) primarily affects children and adolescents, and is characterized by episodic sterile osteomyelitis over several years. No definitive treatment is available. Non‐steroidal anti‐inflammatory drugs ( NSAID ) are common first‐line agents, but provide limited improvement in bone pain and do not affect disease duration. Several agents are utilized in the case of non‐response to NSAID , including corticosteroids, methotrexate, and tumor necrosis factor‐blocking agents. Bisphosphonates are increasingly being used. Most case series involve cyclic i.v. pamidronate, but this restricts the social lives of children and their families. Although oral medication has advantages over cyclic i.v. infusion because it does not require repeated hospital admissions, there have been no reports on treatment with oral bisphosphonates, such as alendronate, in pediatric CRMO patients. This case report describes the use of oral bisphosphonate as an alternative treatment in CRMO patients in whom standard therapy has failed.