Impact of Rheumatologic Comorbidities on Disease Severity in Pediatric Inflammatory Bowel Disease

OBJECTIVE: Rheumatologic diseases (RDs) are major comorbidities that frequently occur with inflammatory bowel disease (IBD). Rheumatologic diseases (RDs), such as juvenile spondylo-arthritis, juvenile idiopathic arthritis, systemic autoinflammatory diseases, vasculitis, and mixed connective tissue diseases, can affect disease activity and clinical course in patients with IBD. Therefore, it is essential to assess children with IBD for comorbid RDs. This study was conducted to evaluate the effect of rheumatologic conditions accompanying IBD on disease severity. MATERIALS AND METHODS: This study was conducted in the Pediatric Gastroenterology and Pediatric Rheumatology Departments of Erciyes University. Patients diagnosed with histopathologically confirmed IBD who were followed between November 2020 and December 2022, including those with concomitant RDs, were included. RESULTS: Forty-seven patients with IBD (ulcerative colitis (UC) and Crohn's disease (CD)), aged 14.0 (2.0-18.0) years [median, min-max], were included in the study. Twenty of 47 patients had accompanying RDs. Findings indicate that baseline disease activity for both CD and UC was higher in patients with IBD accompanied by RDs compared to those with IBD alone, both for CD and UC. In children with UC and CD, the decrease in disease activity scores in the group with concomitant RDs was found to be significantly more limited compared to those with IBD alone (P=.004 for CD; P=.006 for UC). CONCLUSION: These results emphasize the necessity for multidisciplinary management of comorbid RDs in patients with IBD, given its association with increased disease activity.