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Pediatric IBD

Simon R Knowles, Lesley A Graff, Helen Wilding, Catherine Hewitt, Laurie Keefer, Antonina Mikocka-Walus
Background: Quality of life (QoL) is commonly assessed in inflammatory bowel disease (IBD); the relationship of QoL within IBD states and relative to others has not been comprehensively evaluated. This systematic review, published across 2 papers, evaluates 5 key QoL comparisons. Part I, presented here, examines between-disease comparisons: (1) IBD/healthy(general) population and (2) IBD/other medically ill groups. Part II examines within-disease comparisons: (3) active/inactive disease, (4) ulcerative colitis/Crohn's disease, and (5) change over time...
March 19, 2018: Inflammatory Bowel Diseases
Eugene Vortia, Victor E Uko, Belinda Yen-Lieberman, Jill Frawley, Sarah E Worley, Lara Danziger-Isakov, Barbara Kaplan, Lori Mahajan
Background: Tumor necrosis factor alpha (TNF-α) inhibitors are linked with increased risk of reactivation of active tuberculosis. The QuantiFERON-TB Gold In-Tube test is approved for screening latent tuberculosis infection in children and adults. There are limited data on the test performance in children on long-term treatment with TNF-α inhibitors. The objective of this study was to assess the proportion of indeterminate results for the QuantiFERON-TB Gold In-Tube in children with inflammatory bowel disease (IBD) on long-term infliximab treatment and to evaluate the range of interferon-γ responses to mitogen...
March 19, 2018: Inflammatory Bowel Diseases
I Hojsak, Z Mišak, T Trbojević, L Ivković, S Kolaček
BACKGROUND AND STUDY AIMS: The aim of this prospective survey was to determine and compare the knowledge of children with inflammatory bowel disease (IBD) and their parents about their disease. Furthermore, patients and parents were ask to provide the main source for disease related information and to give opinion for possible improvement. PATIENTS AND METHODS: This was a prospective survey which included children with IBD with ≥ 12 years of age and their parents...
April 2017: Acta Gastro-enterologica Belgica
Morgan Lawley, Jessica W Wu, Victor M Navas-López, Hien Q Huynh, Matthew W Carroll, Min Chen, Pavel Medvedev, Andrew S Day, Séamus Hussey, Rotem Sigall-Boneh, Arie Levine, Eytan Wine
OBJECTIVES: Exclusive enteral nutrition (EEN) is an effective induction treatment for pediatric Crohn disease. Given the center-based variation in use and diversity in practice we constructed a survey aimed at sharing experience and strategies in administering EEN, stimulating further research, and optimizing therapy. METHODS: This survey was constructed after consultation with experts and designed to address key knowledge gaps. The survey was disseminated through the Paediatric IBD Porto Group of ESPGHAN, Canadian Children IBD Network, selective experts, and was sent twice through the PEDGI-BB...
March 14, 2018: Journal of Pediatric Gastroenterology and Nutrition
Ondrej Fabian, Ondrej Hradsky, Tereza Drskova, Filip Mikus, Josef Zamecnik, Jiri Bronsky
BACKGROUND: Diagnosis of pediatric inflammatory bowel diseases (IBD) remains challenging. We aimed at the value of immunohistochemical assessment of CD30+ lymphocytes in the intestinal mucosa in differential diagnosis between pediatric Crohn's disease (CD) and ulcerative colitis (UC) and its utility as a predictor of future differentiation in patients with IBD unclassified (IBDU). METHODS: Seventy-four treatment naive pediatric patients with IBD (33 CD, 30 UC and 11 IBDU) were enrolled into the study...
March 14, 2018: Digestive Diseases and Sciences
Way-Seah Lee, Chun-Wei Tee, Zhong-Lin Koay, Tat-Seng Wong, Fatimah Zahraq, Hee-Wei Foo, Sik-Yong Ong, Shin-Yee Wong, Ruey-Terng Ng
AIM: To study implications of measuring quality indicators on training and trainees' performance in pediatric colonoscopy in a low-volume training center. METHODS: We reviewed retrospectively the performance of pediatric colonoscopies in a training center in Malaysia over 5 years (January 2010-December 2015), benchmarked against five quality indicators: appropriateness of indications, bowel preparations, cecum and ileal examination rates, and complications. The European Society of Gastrointestinal Endoscopy guideline for pediatric endoscopy and North American Society for Pediatric Gastroenterology, Hepatology and Nutrition training guidelines were used as benchmarks...
March 7, 2018: World Journal of Gastroenterology: WJG
Shelley A Deeke, Amanda E Starr, Zhibin Ning, Sara Ahmadi, Xu Zhang, Janice Mayne, Cheng-Kang Chiang, Ruth Singleton, Eric I Benchimol, David R Mack, Alain Stintzi, Daniel Figeys
OBJECTIVE: Improved biomarkers are an unmet clinical need for suspected inflammatory bowel disease (IBD). Need is greatest for children, since current biomarkers suffers from low specificity, particularly in this population; thus, invasive testing methods, with the accompanying risk of complications, are necessary. Additionally, current biomarkers do not delineate disease extent assessment for ulcerative colitis (UC), a factor involved in therapeutic decisions. METHODS: Intestinal mucosal-luminal interface (MLI) aspirates from the ascending colon (AC) and descending colon (DC) were collected during diagnostic colonoscopy from treatment-naïve children...
March 12, 2018: American Journal of Gastroenterology
Wendy N Gray, Bonney Reed-Knight, Pamela J Morgan, Erin Holbrook, Subra Kugathasan, Shehzad A Saeed, Lee A Denson, Kevin A Hommel
PURPOSE: This multi-site study examines patient, parent, and pediatric provider perspectives on what is most important for successful transition. DESIGN AND METHODS: Using the Transition Readiness Assessment Questionnaire, 190 participants recruited from two pediatric IBD centers selected the top five skills they considered "most important for successful transition." Rankings were summarized and compared by group. RESULTS: While patients, parents, and clinicians all identified "calling the doctor about unusual changes in health" and "taking medications correctly and independently" as being important, each stakeholder group qualitatively and statistically differed in terms of transition readiness skills emphasized...
March 2018: Journal of Pediatric Nursing
Martine A Aardoom, Maria E Linda Joosse, Andrica C H de Vries, Arie Levine, Lissy de Ridder
Background: Cancer and death are the most severe outcomes that affect patients with inflammatory bowel disease (IBD). These outcomes are even more severe if they occur at a young age but are rare, even in the general population. We conducted a systematic review to provide an overview of all reported pediatric (PIBD) patients with severe outcome. Methods: A literature search identified publications that reported development of cancer or fatal outcome in PIBD patients...
March 7, 2018: Inflammatory Bowel Diseases
Giorgio Ottaviano, Silvia Salvatore, Alessandro Salvatoni, Stefano Martelossi, Alessandro Ventura, Samuele Naviglio
Background and aims: Ocular extraintestinal manifestations (O-EIMs) are known complications of Crohn's disease (CD), ulcerative colitis (UC) and inflammatory bowel disease unclassified (IBD-U). However, data on their prevalence in children are scarce and there are no clear recommendations on which follow-up should be offered. We aimed to review available data on O-EIMs in children. Methods: In January 2018, we performed a systematic review of published English literature using PubMed and EMBASE databases using disease-specific queries...
March 6, 2018: Journal of Crohn's & Colitis
Michael Hunter Lanier, Anup S Shetty, Amber Salter, Geetika Khanna
BACKGROUND: Gadolinium deposition in normal tissues is being increasingly recognized. Children with inflammatory bowel disease (IBD) undergo frequent imaging with contrast-enhanced MR enterography (MRE). PURPOSE: To determine the impact of intravenous (IV) gadolinium in assessment of pediatric IBD by MRE. STUDY TYPE: Retrospective, case series. POPULATION: Radiology information system was searched to identify all children who underwent MRE and endoscopy within 30 days in 2016...
March 5, 2018: Journal of Magnetic Resonance Imaging: JMRI
José M Cabrera, Thomas T Sato
Inflammatory bowel disease (IBD) describes a spectrum of idiopathic, lifelong, and progressive intestinal inflammatory conditions that includes Crohn's disease, ulcerative colitis, and indeterminate colitis. A worldwide increase in the incidence of IBD has been observed. In comparison to adults, IBD occurring during childhood and adolescence has several unique clinical characteristics and surgical management issues. In this article, we provide an overview contrasting these important differences.
March 2018: Clinics in Colon and Rectal Surgery
Harveen Singh, Fariha Balouch, Charlton Noble, Peter Lewindon
OBJECTIVES: Autoimmune liver disease (AILD) incorporates primary sclerosing cholangitis (PSC), autoimmune hepatitis (AIH), and autoimmune sclerosing cholangitis (ASC). ASC is a condition that includes overlap of AIH and PSC. We investigate changes in practice in relation to diagnosis and phenotype over 2 time periods. METHODS: Retrospective chart review was conducted from January 2000 to 2016. Data were divided into two 8-year cohorts, CI and C2. RESULTS: Data were collected in 75 children, 29 in 2000-2007 (C1) and 46 in 2008-2016 (C2)...
February 21, 2018: Journal of Pediatric Gastroenterology and Nutrition
Amitha Prasad Gumidyala, Rachel N Greenley, Jill M Plevinsky, Natasha Poulopoulos, Jose Cabrera, Diana Lerner, Joshua D Noe, Dorota Walkiewicz, Steven Werlin, Stacy A Kahn
Background: Inflammatory bowel diseases (IBD) often begins early in life. Adolescents and young adults (AYA) with IBD have to acquire behaviors that support self-care, effective healthcare decision-making, and self-advocacy to successfully transition from pediatric to adult health care. Despite the importance of this critical time period, limited empirical study of factors associated with transition readiness in AYA exists. This study aimed to describe transition readiness in a sample of AYA with IBD and identify associated modifiable and nonmodifiable factors...
February 15, 2018: Inflammatory Bowel Diseases
Lee A Denson, Ingrid Jurickova, Rebekah Karns, Kelly A Shaw, David J Cutler, David Okou, Anne Dodd, Kathryn Quinn, Kajari Mondal, Bruce J Aronow, Yael Haberman, Aaron Linn, Adam Price, Ramona Bezold, Kathleen Lake, Kimberly Jackson, Thomas D Walters, Anne Griffiths, Robert N Baldassano, Joshua D Noe, Jeffrey S Hyams, Wallace V Crandall, Barbara S Kirschner, Melvin B Heyman, Scott Snapper, Stephen L Guthery, Marla C Dubinsky, Neal S Leleiko, Anthony R Otley, Ramnik J Xavier, Christine Stevens, Mark J Daly, Michael E Zwick, Subra Kugathasan
BACKGROUND & AIMS: Individuals with monogenic disorders of phagocyte function develop chronic colitis that resembles Crohn's Disease (CD). We tested for associations between mutations in genes encoding NADPH oxidases, neutrophil function, and phenotypes of CD in pediatric patients. METHODS: We performed whole-exome sequence analysis to identify mutations in genes encoding NADPH oxidases (such as CYBA, CYBB, NCF1, NCF2, NCF4, RAC1, and RAC2) using DNA from 543 pediatric patients with inflammatory bowel diseases...
February 15, 2018: Gastroenterology
Xiao-Min Zhu, Ying-Zuo Shi, Ming Cheng, Da-Feng Wang, Jian-Feng Fan
IL-6 and IL-23 are both pleiotropic cytokines involved in the regulation of the immune response, inflammation, and hematopoeisis. They also could mediate effector cells and tolerance mediated by cells with regulatory function. Inflammatory bowel disease (IBD) is associated with a reduced ratio of Treg cells ato Th17 effector cells in peripheral blood and is characterised by a pro-inflammatory cytokine microenvironment which supports the continued generation of Th17 cells. It is well described in adults but little is known in a pediatric population...
May 1, 2017: Die Pharmazie
Stefano Nobile, Richard J Grand, Helen M Pappa
OBJECTIVE: In pediatric inflammatory bowel disease (IBD), the prevalence of low bone mineral density (BMD) and bone fractures and the relationship between these are still debated. Our aim was to report data from a cohort of pediatric patients with IBD. PATIENTS AND METHODS: Cross-sectional assessment of growth and BMD [(dual-energy x-ray absorptiometry (DXA)] and retrospective chart review were performed to report the lifetime prevalence of bone fractures and clinical associations with patients' data...
February 12, 2018: European Journal of Gastroenterology & Hepatology
Shlomi Cohen, Christine Martinez-Vinson, Marina Aloi, Dan Turner, Amit Assa, Lissy de Ridder, Victorien M Wolters, Tim de Meij, Patrizia Alvisi, Jiri Bronsky, Uri Kopylov
BACKGROUND: Data on the clinical course and outcomes of pediatric patients with cytomegalovirus (CMV) infection complicating acute severe ulcerative colitis (ASC) are very limited. The aim of our study was to compare outcomes of children with ASC who were CMV positive or CMV negative. METHODS: This was a multicenter retrospective case-controlled study, from centers affiliated with the Pediatric Inflammatory Bowel Disease Porto Group of European Society of Pediatric Gastroenterology, Hepatology, and Nutrition...
March 2018: Pediatric Infectious Disease Journal
Larisa Broglie, Alfred Rademaker, John Galvin, Ayita Ray, William T Tse, Reggie Duerst, Jennifer Schneiderman, Morris Kletzel, Sonali Chaudhury
BACKGROUND: Acute graft versus host disease (aGVHD) affects approximately 30-60% of patients after allogeneic hematopoietic stem cell transplantation (HCT) and our ability to predict who develops this complication and their response to treatment is limited. Fecal calprotectin has recently gained popularity as an effective marker of GI inflammation in patients with Inflammatory Bowel Disease (IBD). METHODS: Fecal calprotectin and albumin were evaluated as prognostic and predictive markers of aGVHD in 60 adult and pediatric HCT patients...
January 31, 2018: Hematology/oncology and Stem Cell Therapy
D R Mager, M W Carroll, E Wine, K Siminoski, K MacDonald, C L Kluthe, P Medvedev, M Chen, J Wu, J M Turner, H Q Huynh
Suboptimal vitamin D (vitD) status and reduced lean body mass are highly prevalent in pediatric inflammatory bowel diseases (IBD). The study objective was to determine sarcopenia prevalence and associations with vitD status in newly diagnosed pediatric IBD. Children with Crohn's disease (CD; n = 58) and ulcerative colitis (UC; n = 27) were included. Primary outcomes included body composition (total/regional/percent fat mass (FM), fat-free mass (FFM), skeletal muscle mass (SMM)), and vitD status (serum 25(OH)D)...
February 1, 2018: European Journal of Clinical Nutrition
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