Title Reumatološke manifestacije u djece s kroničnom upalnom bolešću crijeva Title (english) Rheumatologic manifestations of inflammatory bowel disease in children Author Katarina Sokač Mentor Irena Senečić-Čala (mentor)Committee member Duška Tješić-Drinković (predsjednik povjerenstva)Committee member Marija Jelušić (član povjerenstva)Committee member Irena Senečić-Čala (član povjerenstva)Granter University of Zagreb Defense date and country 2022-07-15, Croatia Scientific / art field, BIOMEDICINE AND HEALTHCARE Abstract Upalna bolest crijeva je sistemska bolest primarno locirana u gastrointestinalnom sustavu, ali može biti udružena i s pojavom ekstraintestinalnih manifestacija. Pritom su najčešće zahvaćeni zglobovi, koža i oči, a rjeđe drugi organi. Brojna su istraživanja o ekstraintestinalnim manifestacijama u odrasloj dobi, ali je vrlo malo takvih istraživanja u pedijatrijskoj populaciji. Ovo istraživanje obuhvatilo je 18 pacijenata s dijagnozom upalne bolesti crijeva koja se liječe i kontroliraju na Klinici za pedijatriju Kliničkog bolničkog centra Zagreb. Cilj ovog rada bio je vidjeti kolika je učestalost ekstraintestinalnih reumatoloških manifestacija u dječjoj dobi te istražiti mogu li se ultrazvučnim pregledom zglobova otkriti promjene na zglobovima prije pojave simptoma njihove zahvaćenosti. Kod svih pacijenata proveden je reumatološki pregled i ultrazvučni pregled zglobova. Gledala se prisutnost izljeva, hipertrofije sinovije i promjena u doplerskom protoku. Analizirale su se razlike u spolu, dobi, duljini trajanja bolesti te tipu upalne bolesti crijeva. Dijagnozu ulceroznog kolitisa imalo je 6 pacijenata, dijagnozu Crohnove bolesti njih 8, a 3 pacijenata imalo je sindrom preklapanja. Prosječna dob pacijenata bila je 16 godina, a prosječna duljina trajanja bolesti je 5 godina. Osmero pacijenata nije imalo simptome zahvaćenosti zglobova, promjene u reumatološkom statusu kao ni promjene na ultrazvučnom pregledu zglobova. Ostalih 10 pacijenata imalo znakove zahvaćenosti zglobova. Veća učestalost zahvaćanja zglobova bila je kod djece s duljim trajanjem bolesti. Sva djeca s duljinom trajanja više od 10 godina imala su promjene na zglobovima. Petero pacijenata imalo je ultrazvučno prikazan izljev u barem jednom zglobu. Hipertrofija sinovije kao i promjena u doplerskom protoku nije dokazana ni kod jednog pacijenta. Tri su pacijenta imala simptome zahvaćenosti zglobova i promjene u reumatološkom statusu, no bez ultrazvučnih promjena. Veća učestalost promjena na zglobovima bila je kod djece s dijagnozom ulceroznog kolitisa, nego kod djece s Crohnovom bolesti. Promjene na zglobovima pronađene su ne samo kod pacijenata s pogoršanjem osnovne bolesti, već i kod pacijenata koji su se nalazili u remisiji bolesti. Dobiveni rezultati upućuju na važnost provođenja preventivnih reumatoloških pregleda i kod djece koja se nalaze u remisiji bolesti, posebno onih s dugim trajanjem bolesti.
Abstract (english) Inflammatory bowel disease is a systemic disease which causes inflammation of gastrointestinal tract but can also be associated with extraintestinal manifestations. Extraintestinal manifestation most commonly affects joints, skin and eyes and rarely other organs. There are many studies about extraintestinal manifestations in adult population, but there are very few studies about that in pediatric population. A total of 18 patients treated and controlled at the Department of Pediatrics at University Hospital Centre Zagreb at were enrolled in this study. The aim of this study was to investigate incidence of extraintestinal manifestations in pediatric population and to investigate if musculoskeletal ultrasound could be used to detect joint involvement before the onset of symptoms. It was performed rheumatological examination and musculoskeletal ultrasound in all patients. It was looked at presence of joint effusion, synovial hypertrophy and change in doppler flow. Differences in gender, age, duration of the disease and type of inflammatory bowel disease were analyzed. There were 6 patients with a diagnosis of ulcerative colitis, 8 patients with Crohn’s disease and 3 patients with undetermined colitis. The average age of patients was 16 years. The average duration of the disease was 5 years. Eight patients had no symptoms of joint involvement, change in rheumatological examination nor ultrasound signs. The other 10 patients had joint involvement signs. There was higher frequency of joint involvement in children with longer disease duration. All patients with disease duration over 10 years had joint involvement. Five patients had effusion seen at ultrasound in at least one joint. Synovial hypertrophy and change in doppler flow were not detected. Three patients had symptoms of joint involvement and changes in rheumatological examination but without ultrasound signs. There was higher frequency of joint involvement at children with ulcerative colitis than in those with Crohn’s disease. Joint changes were detected not only in children with exacerbation of the underlying disease, but also in those in remission. These results indicate importance of implementation of preventive rheumatological examinations in all children, including those in remission of the disease, especially those with longer disease duration.
Keywords
upalna bolest crijeva
periferni artritis
aksijalna artropatija
Crohnova bolest
ulcerozni kolitis
Keywords (english)
inflammatory bowel disease
peripheral arthritis
axial arthropathy
Crohn’s disease
ulcerative colitis
Language croatian URN:NBN urn:nbn:hr:105:651958 Study programme Title: Medicine Type of resource Text File origin Born digital Access conditions Open access Terms of use Created on 2023-02-15 12:53:33
