Related Experiment Video
Updated: Aug 16, 2026
Chronic Salmonella Infection Induced Intestinal Fibrosis
Published on: September 22, 2019
Chronic intestinal inflammation and seronegative spondyloarthropathy in children
F Conti1, O Borrelli, C Anania
1Department of Rheumatology, University of Rome La Sapienza, Rome, Italy.
Insights
Pediatric patients with suspected inflammatory bowel disease often have seronegative spondyloarthropathy with intestinal inflammation. Many showed indeterminate colitis or lymphoid nodular hyperplasia, indicating a potential risk for developing inflammatory bowel disease.
Area of Science:
- Pediatric Gastroenterology
- Rheumatology
- Immunology
Background:
- Association between spondyloarthropathy and intestinal inflammation is known in adults, but less described in children.
- This study focuses on pediatric patients initially referred for suspected inflammatory bowel disease (IBD).
Purpose of the Study:
- To describe intestinal inflammatory lesions and rheumatological features in pediatric patients with seronegative spondyloarthropathy.
- To investigate children presenting with symptoms suggestive of IBD who were found to have spondyloarthropathy.
Main Methods:
- 129 children with suspected IBD were evaluated over 18 months.
- 31 children (ages 5-17) with arthropathy underwent ileo-colonoscopy, biopsy, and rheumatological assessment, including imaging of sacroiliac joints.
- Patients were assessed for HLA B27 status and adherence to European Spondyloarthropathy Study Group criteria.
Main Results:
- Only 7 children had classical IBD (4 ulcerative colitis, 3 Crohn's disease).
- 12 had indeterminate colitis, and 12 showed lymphoid nodular hyperplasia with chronic intestinal inflammation distinct from IBD.
- All patients were HLA B27 negative and met spondyloarthropathy criteria, with 5 classified as undifferentiated.
Conclusions:
- Children investigated for IBD with seronegative spondyloarthropathy exhibit distinct intestinal and rheumatological findings.
- Indeterminate colitis or lymphoid nodular hyperplasia were common, suggesting these patients may be at risk for developing IBD.
- Early identification of these features is crucial for monitoring and potential early intervention in pediatric IBD.
Background:
Spondyloarthropathy in adults has been shown to be associated with either clinical or subclinical intestinal inflammation, however this association has rarely been described in children.
Aim:
To report paediatric patients primarily referred to a paediatric gastroenterology centre for suspected inflammatory bowel disease and found to be affected by a seronegative spondyloarthropathy. Intestinal inflammatory lesions and rheumatological features have been described in them.
Subjects:
During a 18-month period, 129 children were referred because of symptoms and signs suggesting an inflammatory bowel disease; 31 of them (range age: 5-17 years) were selected because they also had signs of axial and/or peripheral arthropathy and form the basis of our study.
Methods:
The investigated patients underwent ileo-colonoscopy with biopsy and rheumatological assessment that also included X-ray and magnetic resonance imaging of the sacroiliac joints.
Results:
Only seven children had a classical inflammatory bowel disease (four had ulcerative colitis, three had Crohn's disease), 12 had an indeterminate colitis, 12 a lymphoid nodular hyperplasia of the distal ileum as main feature. In the latter two groups, endoscopy and histology revealed an intestinal inflammation of chronic type distinct from the classical pattern found in inflammatory bowel disease. All were HLA B27 negative and fulfilled the European Spondyloarthropathy Study Group criteria for spondyloarthropathy (except five children classified as undifferentiated spondyloarthropathy).
Conclusions:
In a group of children primarily investigated for suspected inflammatory bowel disease and also presenting a seronegative spondyloarthropathy we have described both intestinal and rheumatological features. The majority of them exhibited either an indeterminate colitis or a lymphoid nodular hyperplasia of the distal ileum as main feature. These patients may be a population at risk of developing a full inflammatory bowel disease phenotype.
Related Concept Videos
01:25Inflammatory Bowel Disease III: Crohn's Disease
01:17Chronic Bowel Disorders: Introduction
Irritable Bowel Syndrome (IBS) is a common disorder affecting the gastrointestinal tract. The distinctive feature is recurrent abdominal pain associated with altered bowel movements, manifesting as constipation, diarrhea, or fluctuating between both. The...
01:30Inflammatory Bowel Disease II: Crohn's Disease
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by transmural...
01:20Inflammatory Bowel Disease IV: Clinical Manifestations
01:26Inflammatory Bowel Disease I: Introduction
01:20Inflammatory Bowel Disease II: Ulcerative Colitis