We describe the case of an 18-year-old girl with chronic recurrent multifocal osteomyelitis (CRMO) over a period of 10 years. She had suffered predominantly from very painful recurrent swelling of her cheeks. Various therapeutic regimens including nonsteroidal antiinflammatory drugs and steroids had shown only a partial or temporary response. Because tumor necrosis factor-α–blocking agents have been successfully applied in Crohn's-associated CRMO and the related SAPHO (synovitis, acne, pustulosis, hyperostosis, and osteitis) syndrome, tumor necrosis factor-α–blocking therapy with infliximab was initiated. Thereafter, apart from 1 mild episode, no additional recurrences were observed during 21 months of follow-up. Infliximab was well tolerated, and steroids were tapered off. Our observation indicates that infliximab may be an effective therapeutic option in CRMO.
Artificial bone graft substitutes are widely used to fill bony defects after curettage of benign tumors. We sought to evaluate the efficacy of one such bone graft substitute, geneX®, which contains tricalcium phosphate and calcium sulphate; however, during the course of this study we observed a high number of complications.The primary aim of this prospective series was assessment of the effectiveness of geneX® concerning resorption profile and bone healing and remodeling after surgery. We present the types and frequencies of complications observed in patients treated for bone tumors by curettage and filling the defect using geneX®.We planned to study 40 patients; however, after enrollment of the first 31 patients, the study was stopped as a result of serious complications. There were 20 female and 11 male patients with a mean age at surgery of 40 years (range, 6–71 years). Plain radiographs were obtained at different intervals during followup and CT scans were obtained 6 and 12 months postoperatively. Complications were assessed using a 5-point scale according to Goslings and Gouma.Five of the 31 patients (16%) had complications develop after surgery. In three cases, a sterile inflammation adjacent to the geneX® occurred, with delayed wound healing in two patients and local pain. In the third patient, geneX® produced moderate to severe skin damage in the area of the scar, needing revision surgery. In two other patients, inflammatory cystic formations developed in the soft tissues with sizes up to 15 cm, which gradually reduced in size with time. Overall, there were four Grade 1 complications and one Grade 2 according to Goslings and Gouma.We concluded from this series of patients that geneX® causes soft tissue inflammation and pain with its use. Based on this experience we believe that this type of bone substitute should not be used in the treatment of bony defects.Level IV, therapeutic study. See the Instructions for Authors for a complete description of levels of evidence.
Journal Article Dosage of rituximab in systemic sclerosis: 2‐year results of five cases Get access F. C. Moazedi‐Fuerst, F. C. Moazedi‐Fuerst Division of Rheumatology and Immunology Medical University Graz Auenbruggerplatz 15, 8036Graz Austria Search for other works by this author on: Oxford Academic Google Scholar S. M. Kielhauser, S. M. Kielhauser Division of Rheumatology and Immunology Medical University Graz Auenbruggerplatz 15, 8036Graz Austria Search for other works by this author on: Oxford Academic Google Scholar K. Bodo, K. Bodo Department of Pathology Medical University Graz, Auenbruggerplatz 15, 8036Graz Austria Search for other works by this author on: Oxford Academic Google Scholar W. B. Graninger W. B. Graninger Division of Rheumatology and Immunology Medical University Graz Auenbruggerplatz 15, 8036Graz Austria Search for other works by this author on: Oxford Academic Google Scholar Clinical and Experimental Dermatology, Volume 40, Issue 2, 1 March 2015, Pages 211–212, https://doi.org/10.1111/ced.12450 Published: 01 March 2015
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