Case Report

Pamidronate Treatment of Chronic Noninfectious Inflammatory Lesions of the Mandible in Children

SANDRINE COMPEYROT-LACASSAGNE, ALAN M. ROSENBERG, PAUL BABYN, and RONALD M. LAXER

ABSTRACT.

Noninfectious inflammatory lesions of the mandible occur in chronic recurrent multifocal osteomyelitis (CRMO). Diffuse sclerosing osteomyelitis of the mandible (DSOM) is a condition thought to be a localized form of CRMO. Recently, bisphosphonate therapy, and particularly intravenous pamidronate, has been proposed as a treatment for patients with both CRMO and DSOM who do not improve with nonsteroidal antiinflammatory drug treatment. We report our experience using pamidronate in 2 children with chronic noninfectious osteomyelitis affecting the mandible. We describe the clinical and radiographic features and the treatment, side effects, and clinical and radiographic responses. Our experience suggests that pamidronate is an effective second-line therapy. (J Rheumatol 2007;34:1585-9)

Key Indexing Terms:

CHRONIC RECURRENT MULTIFOCAL OSTEOMYELITIS
MANDIBLE
PAMIDRONATE
DIFFUSE SCLEROSING OSTEOMYELITIS OF THE MANDIBLE
BISPHOSPHONATES

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From the Division of Rheumatology and Departments of Paediatrics and Diagnostic Imaging, The Hospital for Sick Children, Toronto; Departments of Paediatrics, Medicine, and Diagnostic Imaging, University of Toronto, Toronto, Ontario; and Section of Rheumatology, Department of Pediatrics, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.

S. Compeyrot-Lacassagne, MD, Division of Rheumatology and Department of Paediatrics, The Hospital for Sick Children, and Department of Paediatrics, University of Toronto; A.M. Rosenberg, MD, FRCPC, Section of Rheumatology, Department of Pediatrics, University of Saskatchewan; P. Babyn, MD, FRCPC, Department of Diagnostic Imaging, The Hospital for Sick Children, and Department of Diagnostic Imaging, University of Toronto; R.M. Laxer, MD, FRCPC, Division of Rheumatology and Department of Paediatrics, The Hospital for Sick Children, and Departments of Paediatrics and Medicine, University of Toronto.

Accepted for publication March 1, 2007.

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