A Case of Infantile Cortical Hyperostosis.

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Patient is a 22-month old female with a diagnosis of infantile cortical hyperostosis. At 2 months of age, she was brought to our hospital because of swelling of the extremities with accompanying respiratory infection. Extremities showed little spontaneous movement. ESR was 33mm/1hr, WBC was 10200, but CRP was negative. Roentgenographic examination revealed callus-like cortical thickening along the mandible, humerus, radius, femur and tibia without involvement of the epiphysis. The inflammatory findings subsided quickly and spontaneously, and at 9 months of age, there was a decrease in the callus-like formation and bowing deformity of the long bone. Painful swelling of the right forearm recurred at 12 months. This was preceded by low grade fever, nasal discharge and sneezing. X-rays showed newly formed periosteal thickening along the ulna. This recurred cortical thickening decreased at 22 months of age. Respiratory infection has occurred almost every month after the onset of infantile cortical hyperostosis. Immunological examination revealed that serum IgM was high at the begining of infantile cortical hyperostosis and increase of serum IgA level was noted at 5 months of age. We suspect that infection contribute to the development of infantile cortical hyperostosis
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