Indomethacin treatment of infantile cortical periostosis in twins

Area of Science:

• Pediatrics
• Genetics
• Rheumatology

Background:

• Infantile cortical periostosis (Caffey's disease) is a rare disorder characterized by bone inflammation.
• Early diagnosis and management are crucial for affected infants.

Observation:

• Twin infants presented with symptoms of Caffey's disease at 2 and 3 weeks of age.
• Initial symptoms included limb swelling, fever, irritability, and bone tenderness.
• Radiographic evidence revealed extensive periosteal new bone formation.

Findings:

• The infants experienced multiple relapses within the first year of life.
• Mandibular and clavicular involvement were observed during some relapses.
• Prednisolone treatment was initiated but later replaced by indomethacin.
• Indomethacin therapy at 3 mg/kg/day proved effective in controlling disease flares and allowed discontinuation of prednisolone.

Implications:

• This case highlights the successful use of indomethacin in managing recurrent infantile cortical periostosis.
• Indomethacin offers a viable alternative for controlling disease activity and reducing reliance on corticosteroids.
• Further research into optimal treatment strategies for Caffey's disease is warranted.