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Table 3 Similarities to and differences between the presentation of systemic juvenile idiopathic arthritis and inflammatory bowel disease in children

From: Inflammatory bowel disease following anti-interleukin-1-treatment in systemic juvenile idiopathic arthritis

 

Juvenile Idiopathic Arthritis

Inflammatory Bowel Disease

Onset of the disease

Acute onset with high, quotidian fevers,

Typically subacute illness with fatigue, anemia, and weight loss. Occasionally more fulminant presentation.

Gastrointestinal symptoms

Frequently abdominal pain, also nausea and anorexia

Loose stools and/or bloody diarrhea, abdominal pain, tenesmus

Muskuloskeletal symptoms

Initially, mild oligoarticular arthritis, frequently severe polyarthritis over the course of the disease

Nonerosive, asymmetric arthritis, affecting the large joints, parallel to intestinal involvement

Skin manifestations

Initial presentation with evanescent, salmon-colored, cutaneous eruption

Erythema nodosum, pyoderma gangrenosum

Laboratory abnormalities

Anemia, reactive thrombocytosis, markedly elevated erythrocyte sedimentation rate and C-reactive protein. Significantly elevated ferritin. Typically negative antinuclear antibodies and rheumatoid factor.

Anemia, elevated erythrocyte sedimentation rate and C-reactive protein, depressed albumin level, occult blood in the stool, elevated fecal calprotectin. Ferritin typically low or normal. Typically negative antinuclear antibodies and rheumatoid factor.