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Erosion Identification in Metacarpophalangeal Joints in Rheumatoid Arthritis using High-Resolution Peripheral Quantitative Computed Tomography
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Upper endoscopic findings in children with active juvenile chronic arthritis

M Ashorn1, P Verronen, T Ruuska

  • 1Department of Paediatrics, University of Tampere, Medical School, Tampere, Finland. merja.ashorn@uta.fi

Acta Paediatrica (Oslo, Norway : 1992)
|July 4, 2003
PubMed

Insights

Juvenile chronic arthritis patients on NSAIDs may experience gastroduodenal damage. Symptomatic children showed more abnormal endoscopic findings, suggesting a need for evaluation.

Area of Science:

  • Pediatric Rheumatology
  • Gastroenterology
  • Medical Research

Background:

  • Juvenile chronic arthritis (JCA) often requires long-term treatment with non-steroidal anti-inflammatory drugs (NSAIDs).
  • NSAID use is associated with gastrointestinal complications, including gastroduodenal mucosal damage.
  • The relationship between JCA, NSAID treatment, and digestive symptoms in children requires further investigation.

Purpose of the Study:

  • To investigate the association between gastroduodenal mucosal damage and digestive tract symptoms in children diagnosed with JCA.
  • To assess the prevalence of gastroduodenal inflammation and Helicobacter pylori infection in these patients.

Main Methods:

  • A prospective, open-label study involving 45 children with active JCA.
  • Gastroscopy was performed to evaluate gastroduodenal mucosa.
  • Gastrointestinal symptoms, medication history, hemoglobin, MCV, ESR, and H. pylori status were analyzed.

Main Results:

  • Seven children (15.6%) exhibited active gastroduodenal inflammation, with two cases of ulcers and two positive for H. pylori.
  • Abnormal endoscopic findings were significantly more prevalent in symptomatic children (75%) compared to asymptomatic ones (38%).
  • Abdominal pain increased significantly after medical therapy initiation.

Conclusions:

  • Endoscopic evaluation is recommended for JCA patients receiving NSAIDs, particularly those presenting with symptoms.
  • The findings highlight the importance of monitoring for gastrointestinal issues in pediatric arthritis patients undergoing NSAID therapy.
Abstract

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