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P297. Arthritis, sacroileal MRI and HLA-B27 in relation to PCDAI and quality of life in pediatric patients with Crohn's disease

G. Veres1, B. Derfalvi2, G. Bozsaki1, D. Szabo1, K. Muller1, A. Arato1, 1Ist Dept. of Pediatrics, Budapest, Hungary, 2IInd Dept. of Pediatrics, Budapest, Hungary

Background

Incidence of arthritis and arthralgia in pediatric patients with Crohn's disease (CD) is 2–15% and 22%, respectively. There is no prospective study to assess joint disease with pediatric CD activity indexes (PCDAI) and quality of life (IMPACT-III) including sacroileal MRI and assessment of HLA-B27.

Methods

Prospective study was conducted in 67 pediatric patients with CD (age: 13.8±3.3 years, male: 38, female: 29, disease duration: 21.7±21 months) to assess the incidence of arthralgia and arthritis. Detailed physical examination by rheumatologist including JAMAR (Juvenile Arthritis Multidimensional Assessment Report), PCDAI, IMPACT-III questionnaire and basic laboratory parameters including CRP, thrombocytes were determined. In addition, sacroileal MRI and HLA-B27 were assessed.

Results

At baseline, incidence of arthritis and arthralgia was 7% and 24%, respectively. Cumulative incidence of arthritis and arthralgia during follow-up was 12% and 43%, respectively. Mostly knee and ankle were affected. There was a significant association between arthritis and lower quality of life (IMPACT-III score, p < 0.01). In addition, incidence of arthritis and arthralgia correlated with higher CRP and PCDAI, independently of age and sex. Arthritis was significantly more common in patients with infliximab treatment. None of the patients had sacroileitis based on MRI and HLA-B27 positivity.

Conclusion

Arthritis and arthralgia in pediatric patients with CD were associated with lower quality of life, higher CRP and PCDAI. Sacroileitis and HLA-B27 positivity were not significant issues in children with CD.