{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,9]],"date-time":"2026-05-09T00:12:02Z","timestamp":1778285522796,"version":"3.51.4"},"reference-count":30,"publisher":"Georg Thieme Verlag KG","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Klin Padiatr"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Chronic recurrent multifocal osteomyelitis is a rare autoinflammatory bone\n                        disorder in children. Vitamin D regulates immune and inflammatory pathways,\n                        but its impact on chronic recurrent multifocal osteomyelitis remains\n                        unclear. This study investigated the relationship between serum\n                        25-hydroxyvitamin D levels and clinical, laboratory, and radiological\n                        characteristics of pediatric chronic recurrent multifocal osteomyelitis.<\/jats:p>\n                  <jats:p>Pediatric chronic recurrent multifocal osteomyelitis patients and age- and\n                        sex-matched healthy controls were retrospectively evaluated. Serum\n                        25-hydroxyvitamin D, inflammatory markers, clinical disease activity score,\n                        and whole-body magnetic resonance imaging findings were analyzed.<\/jats:p>\n                  <jats:p>Thirty-one chronic recurrent multifocal osteomyelitis patients and 31\n                        controls were included. Chronic recurrent multifocal osteomyelitis patients\n                        had significantly lower 25-hydroxyvitamin D levels and a higher frequency of\n                        vitamin D deficiency (p&lt;0.001). Serum 25-hydroxyvitamin D levels\n                        showed no correlation with C-reactive protein, erythrocyte sedimentation\n                        rate, or the neutrophil-to-lymphocyte ratio, but were inversely correlated\n                        with the clinical disease activity score (r=\u2212\u20090.429 and\n                        p=0.020) and the number of magnetic resonance imaging-detected\n                        skeletal lesions (r=\u2212\u20090.376 and p=0.044). Logistic regression\n                        confirmed vitamin D deficiency as independently associated with chronic\n                        recurrent multifocal osteomyelitis (odds ratio=0.59, 95% confidence interva:\n                        0.41\u20130.88, and p=0.007).<\/jats:p>\n                  <jats:p>Vitamin D deficiency is highly prevalent in pediatric chronic recurrent\n                        multifocal osteomyelitis and correlates with disease severity, reflected by\n                        clinical activity and lesion burden, independent of systemic inflammation.\n                        These findings suggest vitamin D as a potential biomarker in chronic\n                        recurrent multifocal osteomyelitis and highlight the need for prospective\n                        studies assessing its therapeutic role.<\/jats:p>","DOI":"10.1055\/a-2859-0223","type":"journal-article","created":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T23:26:22Z","timestamp":1778282782000},"source":"Crossref","is-referenced-by-count":0,"title":["Association Between Serum Vitamin D Levels, Clinical Disease Activity\n                    and Magnetic Resonance Imaging Lesion Burden in Pediatric Chronic Recurrent\n                    Multifocal Osteomyelitis"],"prefix":"10.1055","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6424-6953","authenticated-orcid":false,"given":"Firat","family":"Gundogmus","sequence":"additional","affiliation":[{"name":"Pediatric Rheumatology, Karadeniz Technical University\n                    Faculty of Medicine, Trabzon, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Halil","family":"Kazanasmaz","sequence":"additional","affiliation":[{"name":"Pediatric Rheumatology, Karadeniz Technical University\n                    Faculty of Medicine, Trabzon, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ender Can","family":"Eroglu","sequence":"additional","affiliation":[{"name":"Pediatric Rheumatology, Karadeniz Technical University\n                    Faculty of Medicine, Trabzon, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mukaddes","family":"Kalyoncu","sequence":"additional","affiliation":[{"name":"Pediatric Rheumatology, Karadeniz Technical University\n                    Faculty of Medicine, Trabzon, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2026,5,8]]},"reference":[{"issue":"08","key":"ref1","doi-asserted-by":"publisher","first-page":"1228","DOI":"10.1002\/acr.23462","article-title":"Chronic nonbacterial osteomyelitis\/chronic recurrent multifocal osteomyelitis\n                    study group and the childhood arthritis and rheumatology research alliance\n                    scleroderma, vasculitis, autoinflammatory and rare diseases subcommittee.\n                    consensus treatment plans for chronic nonbacterial osteomyelitis refractory to\n                    nonsteroidal antiinflammatory drugs and\/or with active spinal lesions","volume":"70","author":"Y Zhao","year":"2018","journal-title":"Arthritis Care Res (Hoboken)"},{"issue":"08","key":"ref2","doi-asserted-by":"publisher","first-page":"1455","DOI":"10.3899\/jrheum.141026","article-title":"Whole-body magnetic resonance imaging in chronic recurrent multifocal\n                    osteomyelitis: Clinical longterm assessment may underestimate activity","volume":"42","author":"A M Voit","year":"2015","journal-title":"J Rheumatol"},{"issue":"06","key":"ref3","doi-asserted-by":"publisher","first-page":"542","DOI":"10.1007\/s11914-017-0405-9","article-title":"Chronic recurrent multifocal osteomyelitis (CRMO): Presentation, pathogenesis,\n                    and treatment","volume":"15","author":"S R Hofmann","year":"2017","journal-title":"Curr Osteoporos Rep"},{"issue":"07","key":"ref4","doi-asserted-by":"publisher","first-page":"655","DOI":"10.1055\/s-0033-1335283","article-title":"Typical patterns of bone involvement in whole-body MRI of patients with chronic\n                    recurrent multifocal osteomyelitis (CRMO)","volume":"185","author":"T von Kalle","year":"2013","journal-title":"Rofo"},{"issue":"01","key":"ref5","doi-asserted-by":"publisher","first-page":"276","DOI":"10.1186\/s13075-018-1765-y","article-title":"Vitamin D deficiency is associated with higher disease activity and the risk for\n                    uveitis in juvenile idiopathic arthritis\u2014data from a German inception\n                    cohort","volume":"20","author":"C Sengler","year":"2018","journal-title":"Arthritis Res Ther"},{"issue":"05","key":"ref6","doi-asserted-by":"publisher","first-page":"627","DOI":"10.1097\/JCMA.0000000000000702","article-title":"The correlation between VitD3 levels and the disease activity of childhood-onset\n                    systemic lupus erythematosus","volume":"85","author":"K H Cheng","year":"2022","journal-title":"J Chin Med Assoc"},{"issue":"01","key":"ref7","doi-asserted-by":"publisher","first-page":"124","DOI":"10.1007\/s00247-019-04510-5","article-title":"Imaging mimics of chronic recurrent multifocal osteomyelitis: Avoiding pitfalls\n                    in a diagnosis of exclusion","volume":"50","author":"T S Sato","year":"2020","journal-title":"Pediatr Radiol"},{"issue":"01","key":"ref8","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1186\/s12969-016-0109-1","article-title":"Chronic recurrent multifocal osteomyelitis (CRMO)\u2014advancing the diagnosis","volume":"14","author":"M R Roderick","year":"2016","journal-title":"Pediatr Rheumatol Online J"},{"issue":"09","key":"ref9","doi-asserted-by":"publisher","first-page":"1458","DOI":"10.1016\/j.ard.2024.11.006","article-title":"EULAR\/ACR classification criteria for paediatric chronic nonbacterial\n                    osteomyelitis (CNO)","volume":"84","author":"Y Zhao","year":"2025","journal-title":"Ann Rheum Dis"},{"issue":"07","key":"ref10","doi-asserted-by":"publisher","first-page":"1911","DOI":"10.1210\/jc.2011-0385","article-title":"Evaluation, treatment, and prevention of vitamin D deficiency: An endocrine\n                    society clinical practice guideline","volume":"96","author":"M F Holick","year":"2011","journal-title":"J Clin Endocrinol Metab"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12969-019-0340-7","article-title":"Efficacy of pamidronate in children with chronic non-bacterial osteitis using\n                    whole body MRI as a marker of disease activity","volume":"17","author":"C S Bhat","year":"2019","journal-title":"Pediatr Rheumatol"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"1203","DOI":"10.1093\/rheumatology\/key058","article-title":"The multifaceted presentation of chronic recurrent multifocal osteomyelitis: A\n                    series of 486 cases from the Eurofever international registry","volume":"57","author":"H Girschick","year":"2018","journal-title":"Rheumatology"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"115","DOI":"10.1007\/s00296-019-04400-x","article-title":"Chronic nonbacterial osteomyelitis in children: A multicenter case series","volume":"40","author":"S Concha","year":"2019","journal-title":"Rheumatol Int"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"672","DOI":"10.4103\/ortho. 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P Mallya","year":"2018","journal-title":"Indian J Orthop"},{"key":"ref15","first-page":"1255","article-title":"Chronic non-bacterial osteomyelitis: A retrospective international study on\n                    clinical manifestations and response to treatment","volume":"38","author":"L Gamalero","year":"2020","journal-title":"Clin Exp Rheumatol"},{"issue":"01","key":"ref16","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1186\/s12969-019-0353-2","article-title":"Chronic non-bacterial osteomyelitis: A comparative study between children and\n                    adults","volume":"17","author":"A Skrabl-Baumgartner","year":"2019","journal-title":"Pediatr Rheumatol Online J"},{"key":"ref17","first-page":"493","article-title":"Skull involvement in a pediatric case of chronic recurrent multifocal\n                    osteomyelitis","volume":"77","author":"T Watanabe","year":"2015","journal-title":"Nagoya J Med 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Rheumatol"},{"issue":"01","key":"ref29","doi-asserted-by":"publisher","first-page":"228","DOI":"10.1186\/s13075-023-03195-4","article-title":"Long-term follow-up of children with chronic non-bacterial\n                    osteomyelitis-assessment of disease activity, risk factors, and outcome","volume":"25","author":"C Reiser","year":"2023","journal-title":"Arthritis Res Ther"},{"issue":"07","key":"ref30","doi-asserted-by":"publisher","first-page":"e70061","DOI":"10.1002\/acr2.70061","article-title":"Assessing disease activity in pediatric chronic nonbacterial osteomyelitis: A\n                    proposal for composite scoring, including inactivity measures","volume":"7","author":"C Reiser","year":"2025","journal-title":"ACR Open Rheumatol"}],"container-title":["Klinische 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