AB1426 CHRONIC RECURRENT MULTIFOCAL OSTEOMYELITIS AND BOWEL INFLAMMATION: A MONOCENTRIC COHORT

Background Chronic recurrent multifocal osteomyelitis (CRMO) is a rare autoinflammatory disease of bone primarily affecting children and adolescents. Although CRMO can be associated with inflammatory bowel (IBD) [1] , the prevalence subclinical inflammation its relationship other autoimmune disorders remains uncertain. Objectives This study aims to evaluate in patients potential association celiac disease. Methods Clinical records diagnosed attending Unit Pediatric Rheumatology Gaetano Pini Hospital were retrospectively reviewed. Fecal calprotectin screening for performed all within 2 years after diagnosis. Results Complete data from 24 collected (83% female). The mean age at diagnosis was 10.1 (DS ± 2.7) median follow-up time 68.5 months (IQR 97.5). first symptom onset pain (100%), while only 4 (17%) complained gastrointestinal symptoms (abdominal pain, weight loss, diarrhea). our cohort had no specific comorbidity, except two suffering hemophilia pyoderma gangrenosum, respectively. 96% (23/24) polyostotic During period, 9 (38 %) received non-steroidal anti-inflammatory drugs therapy, 10 (42%) conventional disease-modifying antirheumatic (methotrexate), anti-tumor necrosis factor (TNF) agents 12 (50%) intravenous bisphosphonates. Cumulative treatments are summarized Figure 1. Two patients, both clinical remission off medication, lost follow-up. Calprotectin levels normal 100% 3 (13%) presented positive test IgA anti-tissue transglutaminase antibodies (Table 1). In one these confirmed by duodenal biopsy. After gluten-free diet, patient, who achieved complete remarkable improvement radiological lesions. Conclusion link between intestinal should further investigated since it might open insight into new therapeutic options. experience, controlling may promote better response treatments. On hand, percentage unexplained high, and, this scenario, possible disorder ruled out. Reference Audu GK, Nikaki K, Crespi D, Spray C, Epstein J. J Pediatr Gastroenterol Nutr. 2015 May;60(5):586-91. during time. MTX= methotrexate; TNF= tumor factor; NSAIDs= drugs. Table Case series number Sex Age Comorbidity Poly/monostotic Duodenal biopsy Treatment 1 F No Poly Positive NSAIDs Not yet Pyoderma gangrenosum Bisphosphonates Acknowledgements: NIL. Disclosure Interests Stefania Costi: None declared, Sabino Germinario: Maria Rosa Pellico: Andrea Amati: Maurizio Gattinara: Cecilia Chighizola: Achille Marino: Roberto Caporali Speakers bureau: AbbVie, Amgen, BMS, Celltrion, Fresenius, Galapagos, Janssen, Lilly, Novartis, Pfizer, UCB, Consultant of: UCB.