title: Usefulness of wireless capsule endoscopy for detecting inflammatory bowel disease in children presenting with arthropathy.
abstract: Inflammatory bowel disease (IBD) is a cause of chronic intestinal inflammation in children. In a subset of patients affected by IBD, arthropathy may be the leading presenting sign. In the past years, remarkable advances in gastrointestinal endoscopy techniques have been achieved; recently, the development of capsule endoscopy (CE) provided a non-invasive method for the complete endoscopic evaluation, including small bowel assessment. We report three children suffering from IBD but presenting with articular complaints in whom CE was a useful tool for detecting gut inflammation. Patients were investigated with the wireless CE: PillCam SB2 (Given Imaging, Yoqneam, Israel) capsule, the second-generation capsule, was used in our paediatric patients. Three patients were initially evaluated for arthropathy. Enteropathic arthritis was suspected for gastrointestinal symptoms and/or persistence of inflammatory markers elevation. In one of these children, conventional endoscopy was refused by parents, while in the other two children, CE was proposed as first-line diagnostic tool. In all patients, CE revealed to be safe and provided information that led to diagnosis. Paediatric rheumatologists should consider CE as a valid, non-invasive tool, eventually first level diagnostic approach in order to evaluate the presence of IBD in children presenting with chronic articular complaints.
authors.affiliation: Department of Sciences of Reproduction and Development, Institute of Child Health IRCCS Burlo Garofolo, University of Trieste, Via dell'Istria 65/1, 34100 Trieste, Italy. ataddio@yahoo.it
authors.forename: Andrea
authors.initials: A
authors.lastname: Taddio
authors.forename: Gabriele
authors.initials: G
authors.lastname: Simonini
authors.forename: Paolo
authors.initials: P
authors.lastname: Lionetti
authors.forename: Loredana
authors.initials: L
authors.lastname: Lepore
authors.forename: Stefano
authors.initials: S
authors.lastname: Martelossi
authors.forename: Alessandro
authors.initials: A
authors.lastname: Ventura
authors.forename: Rolando
authors.initials: R
authors.lastname: Cimaz
mesh_terms: D000293:Adolescent; D001171:Arthritis, Juvenile / Q000175:diagnosis* / Q000209:etiology*; D053704:Capsule Endoscopy / Q000379:methods; D002648:Child; D003093:Colitis, Ulcerative / Q000150:complications / Q000175:diagnosis; D003106:Colon / Q000473:pathology; D003424:Crohn Disease / Q000150:complications / Q000175:diagnosis; D003937:Diagnosis, Differential; D005500:Follow-Up Studies; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000150:complications* / Q000175:diagnosis*; D007421:Intestine, Small / Q000473:pathology; D008297:Male; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D016896:Treatment Outcome