Usefulness of wireless capsule endoscopy for detecting inflammatory bowel disease in children presenting with arthropathy

Eur J Pediatr. 2011 Oct;170(10):1343-7. doi: 10.1007/s00431-011-1505-7. Epub 2011 Jun 4.

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.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Arthritis, Juvenile / diagnosis*
  • Arthritis, Juvenile / etiology*
  • Capsule Endoscopy* / methods
  • Child
  • Colitis, Ulcerative / complications
  • Colitis, Ulcerative / diagnosis
  • Colon / pathology
  • Crohn Disease / complications
  • Crohn Disease / diagnosis
  • Diagnosis, Differential
  • Follow-Up Studies
  • Humans
  • Inflammatory Bowel Diseases / complications*
  • Inflammatory Bowel Diseases / diagnosis*
  • Intestine, Small / pathology
  • Male
  • Predictive Value of Tests
  • Sensitivity and Specificity
  • Severity of Illness Index
  • Treatment Outcome