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Arthritis as the initial manifestation of inflammatory bowel disease in early infancy
D M Israel1, A D Olson, N T Ilowite
1Division of Pediatric Gastroenterology and Nutrition, Schneider Children's Hospital of Long Island Jewish Medical Center, New Hyde Park, New York 11042.
Insights
Arthritis can be the first sign of ulcerative colitis in infants. This case highlights that joint inflammation may precede other symptoms in very young children with inflammatory bowel disease.
Area of Science:
- Pediatric Gastroenterology
- Rheumatology
- Inflammatory Bowel Disease
Background:
- Inflammatory bowel disease (IBD) encompasses chronic conditions like ulcerative colitis.
- Extraintestinal manifestations (EIMs) are common in IBD, affecting various organ systems.
- Arthritis is a frequent EIM in adult and pediatric IBD populations.
Observation:
- A 10-month-old infant presented with arthritis as the sole initial clinical symptom.
- The infant's arthritis was later diagnosed as the earliest manifestation of ulcerative colitis.
- This presentation is unusual, as gastrointestinal symptoms typically precede joint issues.
Findings:
- Arthritis can be the primary presenting symptom of ulcerative colitis in infants.
- Early recognition of arthritis in infants may prompt earlier IBD diagnosis.
- This case underscores the diverse clinical spectrum of IBD in early childhood.
Implications:
- Pediatricians and rheumatologists should consider IBD in infants presenting with arthritis.
- Timely diagnosis of IBD can lead to prompt treatment and improved outcomes.
- Further research is needed on the early EIMs of IBD in neonates and infants.
Abstract:
We report a 10-month-old infant who had arthritis as the initial clinical manifestation of ulcerative colitis. Arthritis is considered to be the most common extraintestinal manifestation of IBD in adults and children. This case emphasizes that arthritis may be the earliest manifestation of IBD even in the very young infant.