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For the first time, we report 3 cases of paradoxical chronic recurrent multifocal osteomyelitis after infliximab or adalimumab therapy during the course of Crohn disease. The patients complained of bone pain without joint involvement. At the time of diagnosis of paradoxical reaction, all patients were in remission due to anti\u2010TNF\u03b1 efficiency. Trough levels of anti\u2010TNF\u03b1 were in the expected range, and there were no anti\u2013anti\u2010TNF\u03b1 antibodies. The duration of treatment was between 2 and 26 months. Other causes of CRMO were excluded. All patients recovered after discontinuation of infliximab (n = 2) or adalimumab (n = 1). The increasing use of these therapies leads to new descriptions of paradoxical effects, which clinicians should be aware of.<\/jats:p><\/jats:sec>","DOI":"10.1097\/pg9.0000000000000007","type":"journal-article","created":{"date-parts":[[2020,9,25]],"date-time":"2020-09-25T16:00:09Z","timestamp":1601049609000},"source":"Crossref","is-referenced-by-count":3,"title":["Chronic Recurrent Multifocal Osteomyelitis in Pediatric Crohn Disease, A Paradoxical Effect to Antitumor Necrosis Factor Alpha"],"prefix":"10.1002","volume":"1","author":[{"given":"Anne","family":"Cordesse","sequence":"first","affiliation":[{"name":"Service de Nutrition et Gastroent\u00e9rologie P\u00e9diatriques APHP H\u00f4pital Trousseau France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emmanuelle","family":"Ecochard\u2010Dugelay","sequence":"additional","affiliation":[{"name":"Service de Gastroent\u00e9rologie et Nutrition P\u00e9diatriques APHP H\u00f4pital Robert Debr\u00e9 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