Chronic Non-Bacterial («Sterile») Osteomyelitis in the Practice of Pediatric Rheumatologist, the Contemporary Diagnostic and Treatment Approaches: Literature Review and Own Data Analysis

Abstract

The article presents the current data on the pathogenesis, features of clinical manifestations, and diagnostics of different variants of chronic non-bacterial («sterile») osteomyelitis (CNO). The inherited forms of the disease, such as syndromes of deficiency of the interleukin-1 receptor antagonist (DIRA), sterile pyarthrosis with pyoderma gangrenosum and acne (PAPA-syndrome), dyserythropoietic anemia with chronic non-bacterial osteomyelitis (Majeed-syndrome) are described. The pathogenesis of CNO and related diseases is based on hyperproduction of proinflammatory cytokines, particularly of interleukin-1β and tumor necrosis factor-α. Based on the literature data and our own observations, the recommendations for diagnostics and treatment of CNO are presented.

Keywords

• chronic non-bacterial osteomyelitis (cno)
• diagnostic criteria
• bisphosphonates
• tumor necrosis factor-α inhibitors