Yıl: 2023 Cilt: 13 Sayı: 1 Sayfa Aralığı: 23 - 29 Metin Dili: İngilizce DOI: 10.4274/buchd.galenos.2022.98475 İndeks Tarihi: 24-05-2023

Retrospective Analysis of Children with Chronic Non-bacterial Osteomyelitis

Öz:
Objective: Chronic non-bacterial osteomyelitis (CNO) is a rare autoinflammatory bone disorder which mainly affects children and young adolescents. In this study, we report our single-center experience with pediatric CNO patients. Method: Children diagnosed with CNO at the Department of Pediatric Rheumatology of Hacettepe University between November 2006 and July 2021 were retrospectively reviewed. The demographics, clinical features, laboratory findings, imaging modalities, concomitant diseases, and treatments were recorded. Diagnostic delay was defined as the time interval from symptom onset to diagnosis. Results: A total of 48 patients (52.1% male) with a median age of 13.7 (minimum-maximum: 3.3-20.4) years were included. Local bone pain was the most frequent symptom (72.9%), followed by arthralgia (52.1%), limping or difficulty in walking (43.8%), and back pain (33.3%). Elevated erythrocyte sedimentation rate (52.1%) and high C-reactive protein levels (43.8%) were the most frequently observed laboratory abnormalities. Magnetic resonance imaging (MRI) (regional MRI in 87.5% and whole-body MRI in 66.7% of patients) was widely used in the diagnosis. Non-steroidal anti-inflammatory drugs (NSAIDs) were used in all patients and six patients (12.5%) achieved complete clinical remission with NSAIDs alone. Methotrexate (MTX) (80.9%), biological agents (7.1%), and pamidronate (11.9%) were used as the second-line treatment. Also, 26.4% of patients achieved clinical remission with MTX. Biological treatment was required in a total of 27 patients (56.2%). Conclusion: Local bone pain is a warning sign for CNO diagnosis. Complete clinical remission can be achieved in CNO patients with an escalating anti-inflammatory treatment, having NSAIDs in one end, and biological drugs and bisphosphonates on the other end of the spectrum.
Anahtar Kelime:

Kronik Non-bakteriyel Osteomiyelitli Çocukların Retrospektif Analizi

Öz:
Amaç: Kronik nonbakteriyel osteomiyelit (KNO) nadir görülen bir otoenflamatuvar kemik hastalığıdır ve esas olarak çocukları ve genç adolesanları etkiler. Bu çalışmada pediatrik KNO hastalarına ait tek merkez deneyimimizi sunmayı amaçladık. Yöntem: Hacettepe Üniversitesi Çocuk Romatoloji Anabilim Dalı'nda Kasım 2006-Temmuz 2021 tarihleri arasında KNO tanısı alan çocuklar geriye dönük olarak değerlendirildi. Bulgular: Çalışmaya ortanca yaşı 13,7 (min-maks: 3,3-20,4) yıl olan toplam 48 hasta (%52,1 erkek) dahil edildi. Lokal kemik ağrısı en sık görülen semptomdu (%72,9), bunu artralji (%52,1), topallama veya yürüme güçlüğü (%43,8) ve bel ağrısı (%33,3) izledi. Artmış eritrosit sedimantasyon hızı (%52,1) ve yüksek C-reaktif protein seviyeleri (%43,8) en sık gözlenen laboratuvar anormallikleriydi. Tanıda manyetik rezonans görüntüleme (MRG) (hastaların %87,5'inde bölgesel MRG ve %66,7'sinde tüm vücut MRG) yaygın olarak kullanılmıştır. Tedavide tüm hastalara nonsteroid anti-enflamatuvar ilaçlar (NSAİİ) verildi ve altı hasta (%12,5) sadece NSAİİ tedavisi ile tam klinik remisyon sağladı. İkinci basamak tedavi olarak metotreksat (MTX) (%80,9), biyolojik ajanlar (%7,1) ve pamidronat (%11,9) kullanıldı. Hastaların %26,4'ü MTX ile klinik remisyona ulaştı. Toplam 27 hastada (%56,2) biyolojik ajan tedavisi gerekti. Sonuç: Lokal kemik ağrısı, KNO tanısı için uyarıcı bir işarettir. Spektrumun bir ucunda NSAİİ'lerin diğer ucunda ise biyolojik ilaçlar ve bifosfonatların bulunduğu artan anti-enflamatuvar tedavi planı ile KNO hastalarında tam klinik remisyon elde edilebilir.
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
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APA Kaya Akca Ü, BAYINDIR Y, Bilginer Y (2023). Retrospective Analysis of Children with Chronic Non-bacterial Osteomyelitis. , 23 - 29. 10.4274/buchd.galenos.2022.98475
Chicago Kaya Akca Ümmüşen,BAYINDIR YAGMUR,Bilginer Yelda Retrospective Analysis of Children with Chronic Non-bacterial Osteomyelitis. (2023): 23 - 29. 10.4274/buchd.galenos.2022.98475
MLA Kaya Akca Ümmüşen,BAYINDIR YAGMUR,Bilginer Yelda Retrospective Analysis of Children with Chronic Non-bacterial Osteomyelitis. , 2023, ss.23 - 29. 10.4274/buchd.galenos.2022.98475
AMA Kaya Akca Ü,BAYINDIR Y,Bilginer Y Retrospective Analysis of Children with Chronic Non-bacterial Osteomyelitis. . 2023; 23 - 29. 10.4274/buchd.galenos.2022.98475
Vancouver Kaya Akca Ü,BAYINDIR Y,Bilginer Y Retrospective Analysis of Children with Chronic Non-bacterial Osteomyelitis. . 2023; 23 - 29. 10.4274/buchd.galenos.2022.98475
IEEE Kaya Akca Ü,BAYINDIR Y,Bilginer Y "Retrospective Analysis of Children with Chronic Non-bacterial Osteomyelitis." , ss.23 - 29, 2023. 10.4274/buchd.galenos.2022.98475
ISNAD Kaya Akca, Ümmüşen vd. "Retrospective Analysis of Children with Chronic Non-bacterial Osteomyelitis". (2023), 23-29. https://doi.org/10.4274/buchd.galenos.2022.98475
APA Kaya Akca Ü, BAYINDIR Y, Bilginer Y (2023). Retrospective Analysis of Children with Chronic Non-bacterial Osteomyelitis. Journal of Behçet Uz children's hospital (Online), 13(1), 23 - 29. 10.4274/buchd.galenos.2022.98475
Chicago Kaya Akca Ümmüşen,BAYINDIR YAGMUR,Bilginer Yelda Retrospective Analysis of Children with Chronic Non-bacterial Osteomyelitis. Journal of Behçet Uz children's hospital (Online) 13, no.1 (2023): 23 - 29. 10.4274/buchd.galenos.2022.98475
MLA Kaya Akca Ümmüşen,BAYINDIR YAGMUR,Bilginer Yelda Retrospective Analysis of Children with Chronic Non-bacterial Osteomyelitis. Journal of Behçet Uz children's hospital (Online), vol.13, no.1, 2023, ss.23 - 29. 10.4274/buchd.galenos.2022.98475
AMA Kaya Akca Ü,BAYINDIR Y,Bilginer Y Retrospective Analysis of Children with Chronic Non-bacterial Osteomyelitis. Journal of Behçet Uz children's hospital (Online). 2023; 13(1): 23 - 29. 10.4274/buchd.galenos.2022.98475
Vancouver Kaya Akca Ü,BAYINDIR Y,Bilginer Y Retrospective Analysis of Children with Chronic Non-bacterial Osteomyelitis. Journal of Behçet Uz children's hospital (Online). 2023; 13(1): 23 - 29. 10.4274/buchd.galenos.2022.98475
IEEE Kaya Akca Ü,BAYINDIR Y,Bilginer Y "Retrospective Analysis of Children with Chronic Non-bacterial Osteomyelitis." Journal of Behçet Uz children's hospital (Online), 13, ss.23 - 29, 2023. 10.4274/buchd.galenos.2022.98475
ISNAD Kaya Akca, Ümmüşen vd. "Retrospective Analysis of Children with Chronic Non-bacterial Osteomyelitis". Journal of Behçet Uz children's hospital (Online) 13/1 (2023), 23-29. https://doi.org/10.4274/buchd.galenos.2022.98475