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Impact of Rheumatologic Comorbidities on Disease Severity in Pediatric Inflammatory Bowel Disease
Buket Daldaban Sarıca1, Ayşenur Paç Kısaarslan2, Derya Altay3
1Department of Pediatric Gastroenterology, Hepatology, and Nutrition, Kayseri City Training and Research Hospital, Kayseri, Türkiye.
Insights
Children with inflammatory bowel disease (IBD) and co-occurring rheumatologic diseases (RDs) experience higher disease activity. Early assessment and multidisciplinary management are crucial for these complex pediatric cases.
Area of Science:
- Pediatric Gastroenterology
- Pediatric Rheumatology
- Inflammatory Bowel Disease Research
Background:
- Rheumatologic diseases (RDs) are common comorbidities in pediatric patients with inflammatory bowel disease (IBD).
- Comorbid RDs can significantly impact disease activity and clinical course in IBD patients.
- Assessing children with IBD for co-occurring RDs is essential for comprehensive care.
Purpose of the Study:
- To evaluate the effect of rheumatologic conditions accompanying IBD on disease severity in pediatric patients.
- To investigate the association between comorbid RDs and disease activity in pediatric IBD.
Main Methods:
- Retrospective study conducted at Erciyes University's Pediatric Gastroenterology and Rheumatology Departments.
- Inclusion of pediatric patients with histopathologically confirmed IBD, including those with concomitant RDs, followed between November 2020 and December 2022.
- Analysis of disease activity and treatment response in IBD patients with and without co-occurring RDs.
Main Results:
- Forty-seven pediatric IBD patients (ulcerative colitis and Crohn's disease) were analyzed.
- Twenty out of 47 patients had accompanying RDs, showing higher baseline disease activity for both CD and UC compared to IBD alone.
- A significantly more limited decrease in disease activity scores was observed in IBD patients with concomitant RDs (P=.004 for CD; P=.006 for UC).
Conclusions:
- Comorbid RDs in pediatric IBD are associated with increased disease activity.
- Multidisciplinary management is necessary for pediatric IBD patients with co-occurring RDs.
- Early identification and integrated care can improve outcomes for these complex cases.
Objective:
Rheumatologic diseases (RDs) are major comorbidities that frequently occur with inflammatory bowel disease (IBD). Rheumatologic diseases (RDs), such as juvenile spondylo-arthritis, juvenile idiopathic arthritis, systemic autoinflammatory diseases, vasculitis, and mixed connective tissue diseases, can affect disease activity and clinical course in patients with IBD. Therefore, it is essential to assess children with IBD for comorbid RDs. This study was conducted to evaluate the effect of rheumatologic conditions accompanying IBD on disease severity.
Materials And Methods:
This study was conducted in the Pediatric Gastroenterology and Pediatric Rheumatology Departments of Erciyes University. Patients diagnosed with histopathologically confirmed IBD who were followed between November 2020 and December 2022, including those with concomitant RDs, were included.
Results:
Forty-seven patients with IBD (ulcerative colitis (UC) and Crohn's disease (CD)), aged 14.0 (2.0-18.0) years [median, min-max], were included in the study. Twenty of 47 patients had accompanying RDs. Findings indicate that baseline disease activity for both CD and UC was higher in patients with IBD accompanied by RDs compared to those with IBD alone, both for CD and UC. In children with UC and CD, the decrease in disease activity scores in the group with concomitant RDs was found to be significantly more limited compared to those with IBD alone (P=.004 for CD; P=.006 for UC).
Conclusion:
These results emphasize the necessity for multidisciplinary management of comorbid RDs in patients with IBD, given its association with increased disease activity.
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