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Current issues in pediatric inflammatory bowel disease-associated arthropathies
Sabrina Cardile1, Claudio Romano1
1Sabrina Cardile, Claudio Romano, Department of Pediatrics, University of Messina, 98125 Messina, Italy.
World Journal of Gastroenterology
|January 14, 2014
Summary
Joint involvement, a common extraintestinal manifestation in children with inflammatory bowel disease (IBD), often precedes gastrointestinal symptoms. Early diagnosis and treatment of pediatric IBD-associated arthritis are crucial for better outcomes.
Area of Science:
- Pediatric Rheumatology
- Gastroenterology
- Immunology
Background:
- Joint involvement is the most frequent extraintestinal manifestation in pediatric inflammatory bowel disease (IBD), affecting 16%-33% of patients.
- Peripheral arthritis can manifest before gastrointestinal symptoms, with variable intestinal inflammation patterns.
- Spondyloarthropathy (SpA) and seronegative sacroiliitis are common arthropathies in children with IBD.
Purpose of the Study:
- To review the clinical presentation, pathogenesis, and therapeutic strategies for joint involvement in pediatric IBD.
- To highlight the association between intestinal inflammation and the development of peripheral articular disease in IBD.
- To emphasize the importance of early diagnosis and management of IBD-associated arthritis in children.
Main Methods:
- Review of clinical manifestations and associations in pediatric IBD patients with joint involvement.
- Analysis of the relationship between gut inflammation and articular disease progression.
- Discussion of current therapeutic approaches, including NSAIDs, corticosteroids, physiotherapy, and anti-TNF therapy.
Main Results:
- Peripheral arthritis is a common manifestation, often preceding GI symptoms.
- Intestinal inflammation plays a key role in the pathogenesis of SpA in IBD.
- Pediatric IBD patients show less association with HLA-B27 compared to adults.
Conclusions:
- Early diagnosis of joint involvement in pediatric IBD is essential to prevent progression and complications.
- Therapeutic strategies include NSAIDs, local steroids, physiotherapy, and anti-TNF agents like infliximab.
- Understanding the link between gut and joint inflammation guides effective management of IBD-associated arthropathy.
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