New Insights Into Diffuse Sclerosing Osteomyelitis: Is There a Role of ANA and Vitamin B6?

Diffuse sclerosing osteomyelitis is a poorly understood chronic disease, which appears predominantly in the mandible. Female patients are more often affected than men. DSO is an ultra-rare disease and incidence is unknown; diagnosis can be very challenging; pathogenesis is poorly understood.

In this prospective study, blood samples were collected from a total of 25 patients and analyzed to detect altered laboratory values to have insight into possible pathomechanism. Patients were divided into three groups: Group A: patients with DSO, Group B: patients with osteomyelitis and medication-related osteonecrosis, and Group C: healthy control group.

44% of all patients in group A had elevated Vitamin B6 levels. Compared to groups B and C, these levels were statistically significantly higher (p = 0.011, p = 0.015). 23 patients had increased (92%) antinuclear-antibody-titer (ANA-Titer); in group B, 52% of all patients, and in the healthy control group, 44%.

Elevated ANA titers and elevated vitamin B6 levels provide a possible insight into the pathomechanisms of DSO. Therefore, in the search for the pathogenesis and etiology of DSO, autoimmune processes should also be considered.