Gastrointestinal endoscopic findings of autoimmune and autoinflammatory diseases in pediatric rheumatology patients

OBJECTIVE: Rheumatic diseases in children are chronic and multisystemic diseases. In this study, it was aimed to evaluate gastrointestinal endoscopic findings in children diagnosed as autoimmune or autoinflammatory rheumatic diseases consulted with pediatric gastroenterology for gastrointestinal complaints.
METHODS: The patients followed up by the Pediatric Rheumatology Department and consulted to the Pediatric Gastroenterology Department due to gastrointestinal complaints were included in the study. File records of the patients were analyzed retrospectively.
RESULTS: A total of 28 patients were included in the study. Twelve of the patients had autoimmune disease (Juvenile idiopathic arthritis [JIA], systemic lupus erythematosus, Sjögren’s syndrome, and scleroderma) and the other 16 had autoinflammatory disease (familial Mediterrnean fever, hyper Immunoglobulin D syndrome, undifferantiated systemic autoinflammatory disease, and systemic JIA). Four of the patients with familial Mediterrnean fever also diagnosed as JIA. The mean age of the patients was 11.7±3.5 years. The main gastrointestinal complaints of patients with both autoimmune and autoinflammatory diseases were abdominal pain and diarrhea. Inflammatory bowel disease was found in 33% of those with autoimmune disease and 56% of those with autoinflammatory disease in patients underwent endoscopic evaluation. M694V mutation was present in 62% of the patients with autoinflammatory disease presented with gastrointestinal complaints.
CONCLUSION: Both autoimmune and autoinflammatory rheumatic diseases can cause gastrointestinal complaints and should be referred to a pediatric gastroenterologist for early diagnosis.

Çocuk romatoloji hastalarýnda otoimmün ve otoinflamatuvar hastalýklarýn gastrointestinal endoskopik bulgularý

Amaç: Çocuklarda romatizmal hastalýklar, kronik multisistemik hastalýklardýr. Bu çalýþmada otoimmün veya otoinflamatuvar romatizmal hastalýðý olan çocuklarda gastrointestinal endoskopik bulgularýn deðerlendirilmesi amaçlandý.
Yöntem: Çocuk Romatoloji Bölümü tarafýndan takip edilen ve gastrointestinal þikayetleri nedeniyle Çocuk Gastroenteroloji Bölümü'ne konsülte edilen hastalar çalýþmaya dahil edildi. Hastalarýn dosya kayýtlarý geriye dönük olarak incelendi.
Bulgular: Çalýþmaya toplam 28 hasta dahil edildi. Hastalarýn on ikisinde otoimmün hastalýk (juvenil idiopatik artrit, sistemik lupus eritematozis, Sjögren sendromu, skleroderma) ve diðer 16'sýnda otoinflamatuvar hastalýk (ailevi Akdeniz ateþi, hiper IgD sendromu, tanýmlanmamýþ sistemik otoinflamatuvar hastalýk, sistemik juvenil idiopatik artrit) vardý. Ailevi Akdeniz ateþli hastalarýn dördü ayrýca juvenil idiopatik artrit tanýsý aldý. Hastalarýn ortalama yaþý 11.7 + 3.5 yýl idi. Hem otoimmün hem de otoinflamatuvar hastalýðý olan hastalarýn baþlýca gastrointestinal þikayetleri karýn aðrýsý ve ishaldi. Endoskopik deðerlendirme yapýlan hastalardan otoimmün hastalýðý olanlarýn %33'ünde ve otoinflamatuvar hastalýðý olanlarýn % 56'sýnda inflamatuvar barsak hastalýðý saptandý. Gastrointestinal þikayetlerle baþvuran otoinflamatuvar hastalýklý hastalarýn % 62'sinde M694V mutasyonu vardý.
Sonuç: Hem otoimmun hem de otoinflamatuvar romatizmal hastalýklar gastrointestinal þikayetlere neden olabilir ve erken taný için bir çocuk gastroenterolojisi uzmanýna sevk edilmelidir. (NCI-2021-3-47/R2)