Development of crohn's disease following treatment for juvenile idiopathic arthritis in a nigerian child: Case report and review of literature

Abstract

Juvenile idiopathic arthritis (JIA) and Crohn's disease (CD) are diseases that are rarely seen in the black African child. CD has been reported to occur following therapy with etanercept in JIA patients. We report the case of a Nigerian child with JIA who developed CD following treatment for JIA. A 9-year-old male with JIA was referred to the pediatric gastroenterology unit of the Lagos University Teaching Hospital on the account of chronic diarrhea with occasional passage of bloody stools. He had been on prednisolone and methotrexate which had controlled the joint flares. Colonoscopy revealed extensive colitis, ulcers, abscesses, and ileocecal disease. Histology confirmed the CD. In view of the unavailability of the recommended treatment, namely biologics in the country and financial constraints; steroids; and sulfasalazine were added to his treatment regimen, and subsequently, he has made significant clinical improvement.

Inflammatory Bowel Disease as a Paradoxical Reaction to Anti-TNF-α Treatment—A Review

“…The treatment of the disease aims at decreasing disease activity, the most-used therapies being NSAIDs, steroids, conventional synthetic (cs)DMARDs and biological (b)DMARDs [ 42 ]. Gastrointestinal (GI) disease appears to be one of the documented extra-articular manifestations of JIA [ 43 , 44 , 45 ]. On the other hand, 16–33% of children with IBD experience joint involvement over the course of the illness [ 43 , 44 , 45 ].…”

“…Gastrointestinal (GI) disease appears to be one of the documented extra-articular manifestations of JIA [ 43 , 44 , 45 ]. On the other hand, 16–33% of children with IBD experience joint involvement over the course of the illness [ 43 , 44 , 45 ]. IBD is a rare comorbidity of JIA, with its subtypes: UC, CD or indetermined IBD [ 46 ].…”