Document Detail


Gut inflammation in children with late onset pauciarticular juvenile chronic arthritis and evolution to adult spondyloarthropathy--a prospective study.
MedLine Citation:
PMID:  8164217     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Ileocolonoscopy with biopsy of the colon and terminal ileum was performed prospectively on 12 patients under age 16 with late onset juvenile chronic arthritis (JCA). Inflammatory gut lesions were seen in 9 of these 12 patients; 4 were of the acute type, 5 of the chronic type. Chronic gut inflammation was related to axial inflammatory complaints, inflammatory serum variables, thrombocytosis and sacroiliac radiological abnormalities. A 2nd ileocolonoscopy was performed on 5 of the 12 patients, and a 3rd ileocolonoscopy on 2 of these with persistent synovitis. Gut inflammation and joint inflammation were related; moreover, all 5 patients had chronic inflammatory lesions by the time of the last investigation, one presented with Crohn's disease. The 12 patients were reviewed 3 to 9 years after the first ileocolonoscopy. Four patients were in remission, including the 3 patients with initial normal gut histology. Five patients had developed ankylosing spondylitis (AS), a 6th patient possible AS. Axial inflammatory complaints, a family history of spondyloarthropathies, HLA-B27 positivity, early sacroiliac and peripheral joints radiographic changes, persistence of inflammatory serum variables, thrombocytosis and chronic inflammatory lesions on gut biopsy, are predictive factors in juveniles for evolution to AS. Late onset pauciarticular JCA represents a form of spondyloarthropathy similar to adolescent forms. Persistent gut inflammation could play a role in the pathogenesis of the disease and persistent synovitis.
Authors:
H Mielants; E M Veys; C Cuvelier; M De Vos; S Goemaere; M Maertens; R Joos
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of rheumatology     Volume:  20     ISSN:  0315-162X     ISO Abbreviation:  J. Rheumatol.     Publication Date:  1993 Sep 
Date Detail:
Created Date:  1994-05-26     Completed Date:  1994-05-26     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7501984     Medline TA:  J Rheumatol     Country:  CANADA    
Other Details:
Languages:  eng     Pagination:  1567-72     Citation Subset:  IM    
Affiliation:
Department of Rheumatology, Ghent State University Hospital, Belgium.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Arthritis, Juvenile Rheumatoid / complications*,  immunology
Child
Colon / pathology
Colonoscopy
Enteritis / etiology*
Female
Follow-Up Studies
HLA-B27 Antigen / analysis
Humans
Ileum / pathology
Male
Prospective Studies
Spondylitis, Ankylosing / etiology*
Chemical
Reg. No./Substance:
0/HLA-B27 Antigen

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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