scholarly journals Update: Cytokine Dysregulation in Chronic Nonbacterial Osteomyelitis (CNO)

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Sigrun R. Hofmann ◽  
Angela Roesen-Wolff ◽  
Gabriele Hahn ◽  
Christian M. Hedrich
Keyword(s):  
Musculoskeletal System ◽  
High Titer ◽  
Unknown Origin ◽  
Chronic Recurrent Multifocal Osteomyelitis ◽  
Severe Form ◽  
Autoinflammatory Disorder ◽  
Clinical Criteria ◽  
Multifocal Osteomyelitis ◽  
Cytokine Dysregulation ◽  
Chronic Nonbacterial Osteomyelitis

Chronic nonbacterial osteomyelitis (CNO) with its most severe form chronic recurrent multifocal osteomyelitis (CRMO) is a non-bacterial osteitis of yet unknown origin. Secondary to the absence of both high-titer autoantibodies and autoreactive T lymphocytes, and the association with other autoimmune diseases, it was recently reclassified as an autoinflammatory disorder of the musculoskeletal system. Since its etiology is largely unknown, the diagnosis is based on clinical criteria, and treatment is empiric and not always successful. In this paper, we summarize recent advances in the understanding of possible etiopathogenetic mechanisms in CNO.

scholarly journals Clinical and Diagnostic Considerations for Atypical, Adult Onset Presentation of Chronic Recurrent Multifocal Osteomyelitis (CRMO)

2019 ◽  
Vol 2019 ◽  
pp. 1-8
Author(s):  
Stacey Mahady ◽  
Amit Ladani
Keyword(s):  
Bone Biopsy ◽  
Delayed Diagnosis ◽  
Chronic Recurrent Multifocal Osteomyelitis ◽  
The Elderly ◽  
Severe Form ◽  
X Rays ◽  
Elderly Age ◽  
Bony Lesions ◽  
Multifocal Osteomyelitis ◽  
One Year

Chronic recurrent multifocal osteomyelitis (CRMO) is the most severe form of chronic nonbacterial osteomyelitis (CNO) and is a rare autoinflammatory bone disorder that mostly affects children and adolescents. CRMO is a diagnosis of exclusion, resulting in often-delayed diagnosis with over one year on average from onset of symptoms to time of diagnosis. Initial diagnosis is rare in adults and previously undocumented in the elderly (age greater than 65). We highlight a case of a 74-year-old elderly Caucasian female with a history of palmoplantar pustular psoriasis who presented with pelvic and hip pain. Imaging findings included multiple bony lesions on x-rays, increased uptake in the left side of the pelvis, ileum, proximal sternum, and bilateral medial clavicles on nuclear bone scan. Bone biopsy histologic results of marrow fibrosis and plasma cell infiltrate indicative of chronic inflammation lead to the diagnosis of CRMO. This case highlights that while CRMO is typically a disease with childhood onset, it, while rare, can also present in adults and now has presented in the elderly, remaining an important part of the differential diagnosis of bone pain in adults and the elderly in addition to infectious osteomyelitis and malignancy when imaging reveals multiple bony lesions. This in turn will facilitate the reduction of unnecessary medical treatment and antibiotics.

scholarly journals Unusual Manifestation of Ulcerative Colitis

2019 ◽  
Vol 2019 ◽  
pp. 1-3 ◽  
Author(s):  
Amna Basheer M. Ahmed ◽  
Badr M. Rasheed Alsaleem
Keyword(s):  
Ulcerative Colitis ◽  
Unknown Origin ◽  
Chronic Recurrent Multifocal Osteomyelitis ◽  
Deficiency Anemia ◽  
Rheumatic Manifestations ◽  
Multifocal Osteomyelitis ◽  
Inflammatory Bowel ◽  
Chronic Multifocal Osteomyelitis ◽  
Relationship Of ◽  
The Relationship

The relationship of inflammatory bowel disease (IBD) and chronic recurrent multifocal osteomyelitis (CRMO) is understood as extraintestinal rheumatic manifestations. CRMO is a chronic, relapsing, inflammatory, noninfectious disorder of the skeletal system of unknown origin. The disease course is not always recurrent. The association of CRMO and ulcerative colitis (UC) is very rarely reported. We report a case of a 10-year-old Saudi female who was diagnosed with CRMO, when she developed fever in association with left foot pain, and ulcerative colitis was confirmed endoscopically and histologically based on a previous settled diarrheal illness and severe iron deficiency anemia which required blood. Both conditions responded well to IBD therapy. To the best of our knowledge, this is the first reported case of chronic, multifocal osteomyelitis associated with pediatric UC in Saudi Arabia. This report supports the use of IBD therapy in treating CRMO.

Chronic Nonbacterial Osteomyelitis: Pathophysiological Concepts and Current Treatment Strategies

2016 ◽  
Vol 43 (11) ◽  
pp. 1956-1964 ◽  
Author(s):  
Sigrun R. Hofmann ◽  
Anja Schnabel ◽  
Angela Rösen-Wolff ◽  
Henner Morbach ◽  
Hermann J. Girschick ◽  
...  
Keyword(s):  
Molecular Mechanisms ◽  
Treatment Options ◽  
Treatment Strategies ◽  
Chronic Recurrent Multifocal Osteomyelitis ◽  
Current Treatment ◽  
Multifocal Osteomyelitis ◽  
The One ◽  
Molecular Pathophysiology ◽  
Bone Inflammation ◽  
Chronic Nonbacterial Osteomyelitis

Chronic nonbacterial osteomyelitis (CNO) is an autoinflammatory bone disorder, covering a clinical spectrum with asymptomatic inflammation of single bones at the one end, and chronic recurrent multifocal osteomyelitis (CRMO) at the other end. The exact molecular pathophysiology of CNO remains largely unknown. Provided familial clusters and the association with inflammatory disorders of the skin and intestine suggest a genetic predisposition. Recently, profound dysregulation of cytokine responses was demonstrated in CRMO. Failure to produce antiinflammatory cytokines interleukin (IL)-10 and IL-19 contributes to activation of inflammasomes and subsequent IL-1β release. In IL-10–deficient and in CNO-prone chronic multifocal osteomyelitis mice, IL-1β was linked to bone inflammation. Further, alterations to the gut microbiome were suggested in contributing to IL-1β release from innate immune cells in mice, offering an interesting target in the search for molecular mechanisms in CNO. Here, we summarize clinical presentation and treatment options in CNO/CRMO, current pathophysiological concepts, available mouse models, and promising future scientific directions.

Chronic recurrent multifocal osteomyelitis in children: a new, MRI-based method of quantifying inflammation in the bone

2015 ◽  
Author(s):  
Dionysios Alexandrou ◽  
Benjamin Jacobs ◽  
O'Donnell Paul ◽  
Rikin Hargunani ◽  
Ananya Guha ◽  
...  
Keyword(s):  
Chronic Recurrent Multifocal Osteomyelitis ◽  
Multifocal Osteomyelitis
Sign in / Sign up

Export Citation Format

Share Document