Juvenil idiyopatik artritli çocuklarda fonksiyonel gastrointestinal hastalıkların sıklığı

Year 2020, Volume: 45 Issue: 4, 1768 - 1774, 27.12.2020

Sibel Balcı , Rabia Miray Kisla Ekinci , Eray Akay İlksen Demir Mahir Serbes Dilek Doğruel Derya Altintas , Gökhan Tümgör

Abstract

Amaç: Bu çalışmada juvenil idiyopatik artriti (JIA) olan çocuklarda fonksiyonel gastrointestinal hastalıklar (FGH) görülme sıklığının sağlıklı çocuklarla karşılaştırması amaçlanmıştır.
Gereç ve Yöntem: Bu vaka-kontrol çalışması Ekim 2012 ve Nisan 2019 tarihleri arasında izlemde olan JIA tanılı 193 çocuk ve 139 sağlıklı kontrol çocuk içermektedir. Demografik özellikler, hastalık karakteristikleri, tedavi yaklaşımları geriye dönük olarak toplandı. Çalışma yürütüldüğü esnada laboratuvar parametreleri kaydedildi. FGH tanısı Roma IV kriterlerine göre değerlendirildi.. Cinsiyet, hastalık başlangıç yaşı, laboratuvar parametreleri, tedavi yaklaşımları ve hastalığın klinik durumu iki grup arasında karşılaştırıldı.
Bulgular: Çalışma esnasında ortalama yaş JIA hastalarında 12,05±4,05 yıl ve kontrol grubunda 9,01±3,97 yıl idi. FGH hastalık sıklığı JIA hastalarında (%21,8 n=42) kontrol grubuna göre (%13,7, n=19) anlamlı düzeyde yüksekti. FGH subtipleri açısından JIA hastaları ve kontrol grup arasında istatistiksel anlamlılık yoktu. Demografik ve klinik parametreler FGH varlığına göre gruplandırılan JIA hastaları arasında farklı değildi.
Sonuç: JIA hastalarında kontrol grubuna göre FGH daha sık görülmektedir. Sonuçlarımızın destekleyici daha fazla çalışmaya ihtiyaç duyulmaktadır.

Keywords

juvenil idiyopatik artrit, fonksiyonel gastrointestinal hastalıklar, irritabl barsak sendromu, fonksiyonel dispepsi, fonksiyonel konstipasyon

Supporting Institution

Yok

Frequency of functional gastrointestinal disorders in children with juvenile idiopathic arthritis

Abstract

Purpose: The aim of this study was to compare the frequency of functional gastrointestinal diseases (FGIDs) in juvenile idiopathic arthritis (JIA) patients with healthy control children.
Materials and Methods: This case-control study includes 193 children with JIA followed-up between October 2012 to April 2019 and 139 healthy control children. Demographic features, disease characteristics, treatment modalities were collected retrospectively. Laboratory parameters were recorded at the study enrollment. FGIDs diagnosis were assessed by utilizing Rome IV criteria. Gender, age at disease onset, laboratory parameters, treatment modalities, and clinical status of the disease were compared between the groups.
Results: The mean age at study enrollment was 12.05±4.05 and 9.01±3.97 years in children with JIA and healthy control group, respectively. The frequency of FGIDs was significantly higher in JIA patients (13.7%, n=19) than in healthy control group (21.8%, n=42). There was no statistical significance between JIA patients and healthy control group in terms of FGIDs subtypes. Demographic and clinical parameters did not differ between JIA patients grouped according to FGIDs presence.
Conclusion: FGIDs is more frequent in JIA patients than healthy controls. Further studies are needed to support our results.

Keywords

Juvenile idiopathic arthritis, Functional gastrointestinal disorders, Irritable bowel syndrome, Functional dyspepsia, Functional constipation

References

• 1. Yilmaz M, Kendirli SG, Altintas DU, Karakoc GB, Inal A, Kilic M. Juvenile idiopathic arthritis profile in Turkish children. Pediatr Int. 2008; 50:154-158. https://doi.org/10.1111/j.1442-200X.2008.02543.x.
• 2. Barut K, Adrovic A, Şahin S, Kasapçopur Ö. Juvenile Idiopathic Arthritis. Balkan Med J. 2017; 34:90-101. https://doi.org/10.4274/balkanmedj.2017.0111.
• 3. Petty RE, Southwood TR, Manners P, Baum J, Glass DN, Goldenberg J, et al. International League of Associations for Rheumatology classification of juvenile idiopathic arthritis: second revision, Edmonton, 2001. J Rheumatol. 2004; 31:390-392.
• 4. Giancane G, Alongi A, Ravelli A. Update on the pathogenesis and treatment of juvenile idiopathic arthritis. Curr Opin Rheumatol. 2017; 29:523-529. https://doi.org/10.1097/BOR.0000000000000417.
• 5. Poddighe D, Romano M, Gattinara M, Gerloni V. Biologics for the Treatment of Juvenile Idiopathic Arthritis. Curr Med Chem. 2018; 25:5860-5893. https://doi.org/10.2174/0929867325666180522085716.
• 6. Horneff G. Safety of biologic therapies for the treatment of juvenile idiopathic arthritis. Expert Opin Drug Saf. 2015; 14:1111-1126. https://doi.org/10.1517/14740338.2015.1042453.
• 7. Hyams JS, Di Lorenzo C, Saps M, Perera BJC, Benninga MA. Functional disorders: children and adolescents. Gastroenterology. 2016; 150 e2:1456–1468. [Online ahead of print]. https://doi.org/10.1053/j.gastro.2016.02.015.
• 8. Koloski NA, Talley NJ, Boyce PM. Epidemiology and health care seeking in the functional GI disorders: a population-based study. Am J Gastroenterol. 2002; 97:2290–2299. https://doi.org/10.1111/j.1572-0241.2002.05783.x.
• 9. Keely S, Walker MM, Marks E, Talley NJ. Immune dysregulation in the functional gastrointestinal disorders. Eur J Clin Investig. 2015; 45:1350–1359. https://doi.org/10.1111/eci.12548.
• 10. Holtmann G, Shah A, Morrison M. Pathophysiology of Functional Gastrointestinal Disorders: A Holistic Overview. Dig Dis. 2017; 35:5-13. https://doi.org/10.1159/000485409
• 11. Ekinci RMK, Balcı S, Akay E, Tumgor G, Dogruel D, Altintas DU, et al. Frequency of functional gastrointestinal disorders in children with familial Mediterranean fever. Clin Rheumatol. 2019; 38: 921-926. https://doi.org/10.1007/s10067-019-04452-1
• 12. Kisla Ekinci RM, Balcı S, Mart OO, Tumgor G, Yavuz S, Celik H, et al. Is Henoch-Schönlein purpura a susceptibility factor for functional gastrointestinal disorders in children? Rheumatol Int. 2019; 39: 317-322. https://doi.org/10.1007/s00296-018-4129-7
• 13. Börekci E, Celikbilek M, Soytürk M, Akar S, Börekci H, Günaydin I. Functional gastrointestinal disorders in patients with familial Mediterranean fever. Int J Rheum Dis. 2017; 20:2101–2105. https://doi.org/10.1111/1756-185X.12207
• 14. García-Carrasco M, Mendoza-Pinto C, Autrán-Limón MA, Herrera Robles E, Méndez Martínez S, Etchegaray Morales I, et al. Prevalence of functional gastrointestinal disorders in adults with systemic lupus erythematosus. Lupus. 2018; 27:788–793. https://doi.org/10.1177/0961203317747718
• 15. Ford AC, Talley NJ, Walker MM, Jones MP. Increased prevalence of autoimmune diseases in functional gastrointestinal disorders: case-control study of 23471 primary care patients. Aliment Pharmacol Ther. 2014; 40: 827-834. https://doi.org/10.1111/apt.12903
• 16. Rajindrajith S, Zeevenhooven J, Devanarayana NM, Perera BJC, Benninga MA. Functional abdominal pain disorders in children. Expert Rev Gastroenterol Hepatol. 2018; 12:369–390. https://doi.org/10.1080/17474124.2018.1438188
• 17. Wallace CA, Ruperto N, Giannini E; Childhood Arthritis and Rheumatology Research Alliance; Pediatric Rheumatology International Trials Organization; Pediatric Rheumatology Collaborative Study Group. Preliminary criteria for clinical remission for select categories of juvenile idiopathic arthritis. J Rheumatol. 2004; 31: 2290-2294.
• 18. Saps M, Adams P, Bonilla S, Chogle A, Nichols-Vinueza D. Parental report of abdominal pain and abdominal pain-related functional gastrointestinal disorders from a community survey. J Pediatr Gastroenterol Nutr. 2012; 55:707–710. https://doi.org/10.1097/MPG.0b013e3182662401
• 19. Lewis ML, Palsson OS, Whitehead WE, van Tilburg MAL. Prevalence of functional gastrointestinal disorders in children and adolescents. J Pediatr. 2016; 177:39–43.e3. https://doi.org/10.1016/j.jpeds.2016.04.008
• 20. Tanaka Y, Kanazawa M, Fukudo S, Drossman DA. Biopsychosocial model of irritable bowel syndrome. J Neurogastroenterol Motil. 2011; 17:131–139. https://doi.org/10.5056/jnm.2011.17.2.131
• 21. Farmer AD, Aziz Q. Mechanisms of visceral pain in health and functional gastrointestinal disorders. Scand J Pain. 2014; 5:51–60. https://doi.org/10.1016/j.sjpain.2014.01.002
• 22. Ford AC, Lacy BE, Talley NJ. Irritable Bowel Syndrome. N Engl J Med. 2017; 376: 2566-2578. https://doi.org/10.1056/NEJMra1607547
• 23. Bercik P, Verdu EF, Collins SM. Is irritable bowel syndrome a low-grade inflammatory bowel disease? Gastroenterol Clin N Am. 2005; 34:235–245 vi-vii. https://doi.org/10.1016/j.gtc.2005.02.007
• 24. Card TR, Siffledeen J, Fleming KM. Are IBD patients more likely to have a prior diagnosis of irritable bowel syndrome? Report of a case-control study in the General Practice Research Database. United European Gastroenterol J. 2014; 2:505-512. https://doi.org/10.1177/2050640614554217
• 25. Arvonen M, Berntson L, Pokka T, Karttunen TJ, Vähäsalo P, Stoll ML. Gut microbiota-host interactions and juvenile idiopathic arthritis. Pediatr Rheumatol Online J. 2016; 14:44. https://doi.org/10.1186/s12969-016-0104-6
• 26. Karreman MC, Luime JJ, Hazes JMW, Weel AEAM. The Prevalence and Incidence of Axial and Peripheral Spondyloarthritis in Inflammatory Bowel Disease: A Systematic Review and Meta-analysis. J Crohns Colitis. 2017; 11: 631-642. https://doi.org/10.1093/ecco-jcc/jjw199