Rheumatology Advance Access originally published online on July 11, 2008
Rheumatology 2008 47(9):1397-1399; doi:10.1093/rheumatology/ken249
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Clinical outcome in children with chronic recurrent multifocal osteomyelitis
1General Pediatric Department, Saint-Vincent-de-Paul Hospital, Paris, 2General Pediatric Department, Saint-Jacques Hospital, Besançon, 3Rheumatology Department, Cochin Hospital, 4Pediatric Immunology and Haematology Department, Necker Hospital, 5General Pediatric Department, Robert Debré Hospital, Paris and 6Pediatric Department, Edouard Herriot Hospital, Lyon, France.
Correspondence to: C. Catalano-Pons, Service de Pédiatrie Générale, Centre hospitalier d’Avignon, 305, rue Raoul Follereau, 84902 Avignon cedex 9, France. E-mail: chacatalano{at}yahoo.fr.
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Abstract |
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Objective. To determine the clinical outcome of children with chronic recurrent multifocal osteomyelitis (CRMO).
Methods. We retrospectively reviewed clinical, biological and radiological data of children with CRMO at five French paediatric centres. Outcome data were obtained through review of hospital charts and questionnaires sent to all patients to assess disease activity and educational and vocational achievement.
Results. Forty patients were assessed (34 females and 6 males) with a median age at diagnosis of 11.5 yrs (range 2–17). Median number of initial bony lesions was 2 at onset, and 3.5 over disease course. Median time since diagnosis was 3.5 yrs (range 0.5–15) and median duration of active disease 2.7 yrs (range 0.5–13.5). Nine (22.5%) patients had psychological or physical sequelae. Twenty-nine children (72.5%) responded to the questionnaire. Twenty-six had no physical disability as judged by the HAQ 0–1, two had moderate disability (HAQ: 1–2) and one had severe disability (HAQ: 2–3). Seventeen patients (58.6%) had active disease at follow-up (after 6 months to 15 yrs since diagnosis) and continued to have pain (median value of visual analogue scale: 10/100). CRMO had interfered with patient's education in two cases.
Conclusions. Clinical outcome of children with CRMO is generally good, but a sizeable proportion of patients have active disease at follow-up, and a minority of patients can have a severe and prolonged disease course despite intensive treatments. Further studies are required to determine predictive factors for severe disease.
KEY WORDS: Chronic recurrent multifocal osteomyelitis, Children, Outcome
Submitted 21 November 2007;
revised version accepted 9 June 2008.
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