Chronic recurrent multifocal ostemyelitis (CRMO) and activity of immune system

CRMO (chronic recurrent multifocal osteomyelitis) is a rare inflammatory disease observed in children. The clinical forms included non-bacterial osteitis acute or chronic, CRMO and SAPHO (synovitis, acne, pustulosis, hyperostosis and osteitis). The effective therapy is based on non-steroid anti-inflammatory drugs, steroids and bisphosphonates. The clinical course characterizes remission and relapses. The purpose of this study was analysis of immunological parameters in 9 children with diagnosis of CRMO in remission. In one patient the co-existance of Crohn's disease was noted. Study included immunoglobulins and C3c, C4 complement molecules level, number of T, B lymphocytes and NK cells, response to mitogen stimulation. The results showed IgG, IgA and IgM level within normal range for age, increased level of C3c molecule of complement in 5 children, C4 only in one child. The number of T lymphocytes was increased in 2 patients, decreased in 3 patients. CD4:CD8 ratio was within normal range in all patients. The number of activated T lymphocytes (CD3/HLA-DR) was increased in 5 patients. The response to mitogens stimulation (PHA, PWM and antiCD3 antibody) was decreased in 3 patients. There were no relations between the initial clinical symptoms, course of disease and immunological disturbances.