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Chronic Recurrent Multifocal Osteomyelitis Associated With Inflammatory Bowel Disease Successfully Treated With Infliximab

 Shinhyeung Kwak  ;  Dongsub Kim  ;  Joon-sik Choi  ;  Yoonsun Yoon  ;  Eun Sil Kim  ;  Mi Jin Kim  ;  So-Young Yoo  ;  Jong Sup Shim  ;  Yon Ho Choe  ;  Yae-Jean Kim 
 Pediatric Infection & Vaccine, Vol.29(2) : 96-104, 2022-08 
Journal Title
Pediatric Infection & Vaccine
Issue Date
Chronic recurrent multifocal osteomyelitis ; Inflammatory bowel disease ; Crohn’s disease ; Infliximab
Chronic recurrent multifocal osteomyelitis (CRMO) is an inflammatory bone disorder presenting with sterile osteomyelitis, most often presenting in childhood. Although the etiology is understood incompletely, its association with other auto-inflammatory diseases including inflammatory bowel disease (IBD); psoriasis; Wegener’s disease; arthritis; and synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome suggests that dysregulated innate immunity may play an important role in the pathogenesis. We report a case of a 13-year-old boy with CRMO associated with Crohn’s disease (CD) successfully treated with infliximab after failure of non-steroidal anti-inflammatory drug (NSAID) treatment. He initially was diagnosed with CRMO based on symmetric and aseptic bone lesions with no fever, lack of response to antibiotic treatment, vertebral involvement, and normal blood cell counts. Despite five months of NSAID treatment, his musculoskeletal symptoms were aggravated, and he developed gastrointestinal symptoms. Finally, he was diagnosed with CRMO associated with CD. Due to the severity of symptoms, infliximab was initiated and produced symptom improvement. This case supports infliximab as another choice for treatment of bowel symptoms in addition to the bone and joint symptoms of CRMO when other first-line treatments are ineffective.
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1. College of Medicine (의과대학) > Dept. of Pediatrics (소아과학교실) > 1. Journal Papers
Yonsei Authors
Choi, Joon Sik(최준식)
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