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Background <p>Musculoskeletal (MSK) symptoms are the most common extra-articular manifestations of pediatric-onset inflammatory bowel diseases (pIBD), and are associated with a more aggressive disease course. This study aims to characterize MSK manifestations in patients with pIBD, and to seek for predictors of persistently active arthritis one year after pIBD diagnosis.</p> Methods <p>A multicenter, retrospective cohort study was conducted at 25 Italian pediatric rheumatology centers. Patients aged &lt; 18&#xa0;years with pIBD and MSK manifestations, followed for at least one year, were included. Data at onset of first MSK symptom, pIBD diagnosis, and one-year follow-up visit following pIBD diagnosis were collected.</p> Results <p>A total of 180 patients were included, 111 (61.7%) with Crohn’s disease (CD), 55 (30.5%) with ulcerative colitis (UC), and 14 (7.8%) with unclassified IBD (IBDU). Arthralgia (72.8%) and arthritis (69.4%), were the most frequent MSK manifestations. Patients with CD had MSK symptoms prior to pIBD diagnosis more frequently than those with UC/IBDU (51.4% vs. 40.6%). Among the 125 patients with arthritis, 76.8% had peripheral arthritis, 14.4% had axial disease, and 8.8% had both peripheral and axial involvement. The most common articular pattern was oligoarthritis (52.0%), followed by monoarthritis (26.4%) and polyarthritis (21.6%). The most frequently affected joints were the knee, ankle, and hip<b>.</b> On multivariable analysis, antinuclear antibody (ANA) positivity (OR = 3.05, 95% CI: 1.05 – 8.89) and a polyarticular course of arthritis (OR = 3.42, 95% CI: 1.13–10.38) were independently associated with persistence of active arthritis at year 1 after pIBD diagnosis.</p> Conclusions <p>Most patients with pIBD and arthritis presented with peripheral oligoarthritis affecting lower limb joints. A positive ANA status and development of polyarthritis predicted sustained arthritis activity.</p>

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Musculoskeletal manifestations in children with inflammatory bowel disease: a multicenter cohort study (GASTROREUM study)

  • 期刊论文

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  • 发表日期：

    2025年10月10日

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  • Adele Civino,
  • Federico Diomeda,
  • Romina Gallizzi,
  • Marco Gattorno,
  • Silvia Magni-Manzoni,
  • Davide Montin,
  • Gabriele Simonini,
  • Giovanni Conti,
  • Emanuela Del Giudice,
  • Giovanni Filocamo,
  • Fortunata Civitelli,
  • Angela Miniaci,
  • Serena Pastore,
  • Francesco La Torre,
  • Bianca Lattanzi,
  • Angela Mauro,
  • Lorenzo Mambelli,
  • Patrizia Barone,
  • Alma Nunzia Olivieri,
  • Gianluca Vergine,
  • Maria Cristina Maggio,
  • Ilenia Floretta,
  • Simona Campus,
  • Luca Cantarini,
  • Emanuela Sacco,
  • Michela Cappella,
  • Serena Arrigo,
  • Giusyda Tarantino,
  • Manuela Taurisano,
  • Silvia Greco,
  • Rossella Greco,
  • Fabrizio De Benedetti,
  • Francesca Bovis,
  • Angelo Ravelli,
  • Pierandrea Elefante,
  • Alessandra Spagnolo,
  • Francesco Chiarelli,
  • Edoardo Marrani,
  • Chiara Longo,
  • Riccardo Lubrano,
  • Giulia Loiacono,
  • Cecilia Lugarà,
  • Federica D’Amico,
  • Arianna Petrillo,
  • Rosaria Celano,
  • Maria Francesca Gicchino,
  • Francesca Cavataio,
  • Alessandro De Fanti,
  • Valeria Dell’Omo,
  • Elisabetta Cortis,
  • Federica Ferrari,
  • Francesca Ardenti Morini,
  • Francesca Soscia,
  • Maria Pastore,
  • Ilaria Battagliere,
  • Eleonora Prete,
  • Andrea Taddio

摘要

Background

Musculoskeletal (MSK) symptoms are the most common extra-articular manifestations of pediatric-onset inflammatory bowel diseases (pIBD), and are associated with a more aggressive disease course. This study aims to characterize MSK manifestations in patients with pIBD, and to seek for predictors of persistently active arthritis one year after pIBD diagnosis.

Methods

A multicenter, retrospective cohort study was conducted at 25 Italian pediatric rheumatology centers. Patients aged < 18 years with pIBD and MSK manifestations, followed for at least one year, were included. Data at onset of first MSK symptom, pIBD diagnosis, and one-year follow-up visit following pIBD diagnosis were collected.

Results

A total of 180 patients were included, 111 (61.7%) with Crohn’s disease (CD), 55 (30.5%) with ulcerative colitis (UC), and 14 (7.8%) with unclassified IBD (IBDU). Arthralgia (72.8%) and arthritis (69.4%), were the most frequent MSK manifestations. Patients with CD had MSK symptoms prior to pIBD diagnosis more frequently than those with UC/IBDU (51.4% vs. 40.6%). Among the 125 patients with arthritis, 76.8% had peripheral arthritis, 14.4% had axial disease, and 8.8% had both peripheral and axial involvement. The most common articular pattern was oligoarthritis (52.0%), followed by monoarthritis (26.4%) and polyarthritis (21.6%). The most frequently affected joints were the knee, ankle, and hip. On multivariable analysis, antinuclear antibody (ANA) positivity (OR = 3.05, 95% CI: 1.05 – 8.89) and a polyarticular course of arthritis (OR = 3.42, 95% CI: 1.13–10.38) were independently associated with persistence of active arthritis at year 1 after pIBD diagnosis.

Conclusions

Most patients with pIBD and arthritis presented with peripheral oligoarthritis affecting lower limb joints. A positive ANA status and development of polyarthritis predicted sustained arthritis activity.