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Extradigestive manifestations of IBD in pediatrics
1Pediatric Gastroenterology and Hepatology Unit, Department of Pediatrics, University La Sapienza, Rome, Italy. marina.aloi@uniroma1.it
Insights
Inflammatory bowel diseases (IBD) in children and adolescents commonly present with extraintestinal manifestations (EIMs). This review details the prevalence and clinical features of EIMs in pediatric IBD patients.
Area of Science:
- Pediatric Gastroenterology
- Rheumatology
- Ophthalmology
Background:
- Inflammatory bowel diseases (IBD), including Crohn's disease and ulcerative colitis, affect children and adolescents.
- Extraintestinal manifestations (EIMs) occur in about one-third of IBD patients, but data in pediatric populations are limited.
- EIMs involve multiple organ systems and can be linked to disease activity or occur independently.
Purpose of the Study:
- To review the prevalence and clinical aspects of common EIMs in pediatric patients with IBD.
- To highlight specific concerns for children, such as growth failure and metabolic bone disease.
Main Methods:
- Literature review focusing on studies of EIMs in pediatric IBD patients.
- Analysis of data from adult studies where pediatric data is scarce.
- Synthesis of information on organ involvement, disease association, and complications.
Main Results:
- Commonly affected organs include joints, skin, eyes, and the biliary tract.
- Some EIMs correlate with intestinal disease activity, while others are independent.
- Metabolic complications like osteoporosis and growth retardation are significant in pediatric IBD.
Conclusions:
- Pediatric IBD patients experience a range of EIMs affecting various organs.
- Understanding EIMs is crucial for comprehensive management of pediatric IBD.
- Addressing growth and metabolic issues is essential in the care of children with IBD.
Abstract:
Inflammatory bowel diseases (IBD) are often associated with extraintestinal manifestations (EIMs), which occur in approximately one third of patients. There is only few published data on the occurrence of these manifestations in children and adolescents, so most of the data are taken by studies in adult patients. The organs most commonly affected are joints, skin, eyes and biliary tract, although nearly every organ may be involved. Some of the EIMs are clearly related to intestinal disease activity (i.e., erythema nodosum, peripheral arthritis, orofacial lesions), whereas others occur independently (i.e., pyoderma gangrenosum, anterior uveitis/iritis, ankylosing spondylitis, primary sclerosing cholangitis). Many extraintestinal disorders may be direct inflammatory and metabolic complications of the intestinal inflammation (i.e., osteoporosis, growth retardation, nephrolithiasis, ureteral obstruction, thromboembolic disease). In this review we provide an overview on the prevalence and clinical aspects of the more commonly reported EIMs of Crohn's disease and ulcerative colitis in pediatric patients, focusing on specific issues of children affected by IBD (growth failure and metabolic osteopathy).
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