ab215017

Gastrointestinal symptoms and permeability in patients with juvenile idiopathic arthritis

P. Weber¹, T. Brune², G. Ganser³, K.P. Zimmer²

¹University Children's Hospital Basel, Basel, Switzerland; ²University Children's Hospital Münster, Münster and 3Department of Pediatric Rheumatology, Northwest German Center for Rheumatology, Sendenhorst, Germany.

ABSTRACT
Objective
Examining for gastrointestinal involvement in juvenile idiopathic arthritis is an important part of diagnostic and therapeutic procedures. Only few scientific data are available.

Methods
In a prospective study, 41 patients with juvenile idiopathic arthritis were examined for clinical and laboratory data of gastrointestinal involvement. Sugar absorption tests with lactulose, mannitol, and sucrose were applied to assess gastric and intestinal mucosal lesions. Faecal albumin and a1-antitrypsin levels were measured to examine gastrointestinal protein loss, a test for occult blood in stool was administered and Helicobacter pylori serology was performed.

Results
39% of our study population complained of chronic abdominal pain. The patient group showed increased sucrose excretion (p = 0.002), but a normal lactulose/mannitol ratio compared with healthy controls (p = 0.472). 21% of the patients had an elevated faecal a1-antitrypsin level, but only one patient showed occult blood loss. There was no correlation between risk factors and clinical or laboratory signs of gastrointestinal involvement.

Conclusion
We conclude that a high percentage of children and adolescents with juvenile idiopathic arthritis treated with non-steroidal antiinflammatory drugs show clinical or laboratory signs of gastrointestinal involvement.

Key words
Juvenile idiopathic arthritis, nonsteroidal anti-inflammatory drugs, intestinal and gastric permeability, gastrointestinal involvement, faecal a1-antitrypsin level.

Please address correspondence to: Dr. Peter Weber, University Children's Hospital Basel, P.O. Box, CH-4005 Basel, Switzerland.
E-mail: Peter.Weber@unibas.ch