慢性非细菌性骨髓炎:一个典型病例和综述
Qiang Li1, Yiwei Wang1, Fei Liu1
1Departmet of Orthopaedic Surgery, Children's Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.
Frontiers in pediatrics
|March 16, 2026
概括
慢性非细菌性骨髓炎 (CNO) 是一种罕见的自身炎症性骨病. 这一案例突显了在初始治疗失败后,用双酸盐和生物药物成功治疗耐火性CNO.
科学领域:
- 儿科风湿病学 儿科风湿病学
- 自燃性炎症疾病 自燃性炎症疾病
- 骨的新陈代谢 骨的新陈代谢
背景情况:
- 慢性非细菌性骨髓炎 (CNO) 是一种罕见的自身炎症性骨疾病,影响儿童和青少年.
- 它呈现的严重程度各不相同,从轻微到严重的多焦点骨炎.
- 不清楚的病因和非特异性症状使CNO诊断复杂化.
研究的目的:
- 报告一个14岁女孩被诊断患有慢性非细菌性骨髓炎 (CNO) 的病例.
- 为了说明CNO的诊断挑战和治疗进展.
- 突出在耐火性CNO病例中先进疗法的有效性.
主要方法:
- 一名14岁的女性出现了反复出现的关节骨胀和疼痛.
- 诊断涉及广泛的工作,包括成像和活检,不包括感染和恶性瘤.
- 最初的治疗包括NSAIDs和口服药物;升级到双酸盐和生物药物用于耐火症状.
主要成果:
- 根据临床和组织病理学发现,该患者被诊断为CNO.
- 最初的治疗提供了暂时的缓解,但症状复发.
- 升级为静脉注射帕米德罗纳特和皮下阿达利姆巴,在两年随访期间实现了持续的临床缓解.
结论:
- 诊断CNO往往是通过排除,而MRI对评估至关重要.
- NSAIDs是第一线的,但双酸盐和生物药物对于耐火病例至关重要.
- 这一案例强调了需要多学科管理和进一步研究标准化CNO治疗的需要.
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