Histopathological features of gastrointestinal mucosal biopsies in children with juvenile idiopathic arthritis
Related Experiment Video
Updated: Mar 25, 2026
Diagnosis of Hirschsprung's Disease by Immunostaining Rectal Suction Biopsies for Calretinin, S100 Protein and Protein Gene Product 9.5
Published on: April 26, 2019
Judith Pichler1,2, Christina Ong2,3, Neil Shah2,4
1Department of Paediatric and Adolescent Medicine, Medical University of Vienna, Vienna, Austria.
Insights
Juvenile idiopathic arthritis (JIA) patients with gastrointestinal symptoms often show mild gut inflammation. However, some cases exhibit active colitis and eosinophilic infiltrates, warranting further investigation.
Area of Science:
- Pediatric Rheumatology
- Gastroenterology
- Histopathology
Background:
- The link between inflammatory bowel disease and joint issues is known.
- Limited data exists on gut histopathology in juvenile idiopathic arthritis (JIA).
Purpose of the Study:
- To investigate the histopathological gut findings in children with JIA and gastrointestinal symptoms.
- To correlate these findings with JIA subtypes, autoantibodies, and treatments.
Main Methods:
- Retrospective analysis of 33 children (aged 3-16) with JIA and GI symptoms undergoing endoscopy.
- Review of histopathological findings, autoantibodies, and treatment history.
Main Results:
- 85% of children had gut mucosal inflammation, primarily in the colon.
- Mild, nonspecific inflammation was most common (53%), but active colitis (17%) and eosinophilic infiltrates (27%) were also observed.
- Immunomodulator use showed a negative association with eosinophilic inflammation.
Conclusions:
- Most children with JIA and GI symptoms have mild gut inflammation.
- A subset presents with active colitis or significant eosinophilic infiltration, indicating potential for distinct gastrointestinal pathology in JIA.
Background:
The association between inflammatory bowel disease and joint involvement is well established. There is a paucity of data describing histopathological features of the gut in relation to juvenile idiopathic arthritis (JIA).
Methods:
We retrospectively identified 33 (21 male) children aged 3-16 y with JIA (11 with oligoarthritis, 5 with polyarthritis, 8 with systemic onset arthritis, 8 with enthesitis-related arthritis (ERA), and 1 with psoriatic arthritis) with significant gastrointestinal (GI) symptoms who underwent upper and/or lower endoscopy. The histopathological findings were reviewed in addition to presence of autoantibodies and concomitant treatment.
Results:
The most common GI indications for endoscopy were persistent abdominal pain (14/33 (42%)) and diarrhea (10/33 (30%)). Of the 33 children, 28 (85%) had gut mucosal inflammation, mostly affecting the colon (80%). Active inflammation of the gut was found in 5 of 28 (17%) children, and 15 of 28 (53%) children showed mild nonspecific inflammation. Eight patients (27%) had predominantly an eosinophilic infiltrate. Twenty-six patients had previously received treatment for JIA. There was a negative association with the use of immunomodulators and the presence of eosinophil inflammation.
Conclusion:
The majority of children with JIA and GI symptoms have histological evidence of mild nonspecific inflammation, but some having active colitis and prominent eosinophil infiltrate.
More Related Videos
Related Concept Videos
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...
01:20Histology of the Gastrointestinal (GI) Tract
The mucosa is sometimes called a mucous membrane due to its mucus-secreting features. This membrane is composed of epithelium, which directly interacts with ingested substances, and the lamina propria, a layer...
01:27Inflammatory Bowel Disease I: Ulcerative Colitis
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
01:27Histology of the Small Intestine
The intestinal lining features transverse folds called circular folds, each housing fingerlike projections known as intestinal villi. These villi are covered by a layer of simple columnar epithelium, also referred to as...
01:30Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the...
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...