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[Changes in the gastrointestinal system of children with inflammatory systemic connective tissue diseases]
L Rutkowska-Sak1, M Legatowicz-Koprowska, J Ryzko
1Klinika Reumatologii Wieku Rozwojowego Instytutu Reumatologii w Warszawie.
Insights
Juvenile chronic arthritis and related conditions cause gastrointestinal issues, including inflammation and functional impairments. These findings highlight the need for comprehensive gastrointestinal care in pediatric rheumatic diseases.
Area of Science:
- Pediatric Rheumatology
- Gastroenterology
- Systemic Autoimmune Diseases
Context:
- Juvenile chronic arthritis (JCA)
- juvenile systemic erythematosus
- juvenile systemic scleroderma
- gastrointestinal (GI) system involvement
Purpose:
- To assess functional and morphological GI changes in pediatric rheumatic diseases.
- To correlate GI findings with disease severity and potential causative factors.
Summary:
- Endoscopy revealed GI inflammation and atony.
- Ultrasonography and biopsy indicated hepatic, pancreatic, and intestinal changes (inflammation, steatosis, amyloidosis).
- Functional tests showed impaired liver, pancreas, and bowel function, with common food intolerances and malnutrition.
Impact:
- Highlights significant GI morbidity in pediatric rheumatic diseases.
- Suggests multifactorial causes for GI damage, including disease activity, medications, and environmental factors.
- Underscores the importance of evaluating GI health in these patient populations.
Abstract:
Functional and morphological changes of the gastrointestinal system were assessed in patients suffering from juvenile chronic arthritis, juvenile systemic erythematosus and juvenile systemic scleroderma. The results of endoscopic investigation of the gastrointestinal tract showed inflammatory changes and cardiac and pylorus atony. Ultrasonography results suggested hepatic and pancreatic inflammatory changes, steatosis and/or amyloidosis. The above-mentioned changes were confirmed by morphological investigation (biopsy and/or autopsy). The results of the capacity tests performed in JCA (systemic form) patients revealed an impairment of liver detoxication function, and pancreas and bowel functional capacity as well. Additionally, intolerance against lactose, casein and alpha- and beta-lactoglobulin was found in most of the patients. Some symptoms of malnutrition were observed in all of them. Such factors as underlying disease severity, adverse drug effects, environmental factors (infections, nutrition) were taken into consideration as probable causes of the gastrointestinal system damage.