Abstract
The efficacy of diet and its influence on gut microbiome composition has been largely demonstrated in inflammatory bowel disease (IBD). Little is known about its potential in the management of extraintestinal manifestations. We report a successful application of Crohn disease exclusion diet (CDED) in association with infliximab and methotrexate, as salvage therapy in a child affected by chronic recurrent multifocal osteomyelitis (CRMO) and Crohn disease (CD) resistant to optimized therapy. Both intestinal and bone symptoms remitted after the application of CDED. Diet may have acted on common microbic inciting agents that trigger both intestinal and bone inflammation, supporting the role of microbiota in the pathogenesis of IBD-associated extraintestinal manifestations. Our experience suggests the potential benefit of CDED in association with combined therapy in resistant patients affected by CD and extraintestinal manifestations.
Highlights
We read with interest the publication by Starz and colleagues [1] regarding the association of nutritional therapies and gut microbiome modifications in inflammatory bowel diseases (IBD)
We report a successful application of Crohn disease exclusion diet (CDED) in association with infliximab and methotrexate, as rescue therapy in a child affected by chronic recurrent multifocal osteomyelitis (CRMO) and Crohn disease (CD) resistant to optimized therapy
A 10-year-old boy complaining of migrating bone pain was diagnosed with CRMO by MRI and bone biopsy
Summary
Received: 25 August 2021 Accepted: 2 November 2021 Published: 10 November 2021 Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. We read with interest the publication by Starz and colleagues [1] regarding the association of nutritional therapies and gut microbiome modifications in inflammatory bowel diseases (IBD). The efficacy of diet has been demonstrated in IBD [2]. Little is known about its potential in the management of extraintestinal manifestations.
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