Upper gastrointestinal mucosal lesions in children with juvenile idiopathic arthritis before the treatment

Abstract

Upper gastrointestinal mucosal lesions in children with juvenile idiopathic arthritis before the treatmentPatients suffering from collagen tissue diseases, including rheumatic arthritis, rather frequently present gastroduodenal disorders. This is mainly connected with the use of nonsteroidal antiinflammatory drugs (NSAIDs) and glucocorticoids or can be sometimes contributed to the concommitant Helicobacter pylori infection (1-5). The drug-induced mucosal injuries in both adults and children include a variety of alterations ranging from erythematous to ulcerative ones (6). So far, a few number of studies regarding the gastroduodenal endoscopic findings in children with juvenile idiopathic arthritis (JIA) have been performed. Moreover, these studies concerned the children being already treated with NSAIDs (3, 4, 6-9). To our knowledge, the studies on oesophago-gastroduodenal alterations in rheumatic children before the planned medication are lacking.Bearing in mind that JIA as a representative of collagen tissue diseases can produce the damage of the small vessels inside the digestive tract and lead to the ischaemic alterations of them (10), we decided to investigate endoscopically the patients with JIA prior to treatment.