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Pediatric IBD

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https://www.readbyqxmd.com/read/28081040/azathioprine-therapy-in-a-pediatric-tpmt-deficient-patient-still-an-option
#1
S A W van Moorsel, N Bevers, M Meurs, L K van Rossum, P M Hooymans, D R Wong
We describe the case of a pediatric patient on azathioprine therapy with previously undiagnosed homozygote thiopurine S-methyltransferase (TPMT) deficiency, resulting in myelotoxic thiopurine metabolite levels. The patient was successfully treated with a very low azathioprine dose of 50 mg once a week (4% of standard dose), guided by frequent thiopurine metabolite measurement and a close clinical surveillance. We demonstrate that azathioprine therapy still might be an effective and safe therapeutic option in pediatric thiopurine S-methyltransferase-deficient IBD patients...
February 2017: Therapeutic Drug Monitoring
https://www.readbyqxmd.com/read/28079601/infliximab-optimization-based-on-therapeutic-drug-monitoring-in-pediatric-ibd
#2
Tatyana Hofmekler, Madeline Bertha, Courtney McCracken, Benadette Martineau, Elizabeth McKinnon, Bess T Schoen, Barbara O McElhanon, Gayathri Tenjarla, Subra Kugathasan, Cary Sauer
BACKGROUND: Infliximab (IFX) is an effective treatment for the management of moderate to severe inflammatory bowel disease (IBD). Low serum IFX levels are associated with the development of antibodies to IFX (ATI) which subsequently associated with clinical relapse and increased morbidity. The purpose of this study is to examine the relationship between dose and interval to IFX level. Secondary goal is to evaluate the relationship between IFX level and ATI in a pediatric IBD population...
June 21, 2016: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28077249/altered-mucosal-expression-of-micrornas-in-pediatric-patients-with-inflammatory-bowel-disease
#3
Nóra Judit Béres, Zoltán Kiss, Zsófia Sztupinszki, Gábor Lendvai, András Arató, Erna Sziksz, Ádám Vannay, Attila J Szabó, Katalin Eszter Müller, Áron Cseh, Kriszta Boros, Gábor Veres
INTRODUCTION: MicroRNAs (miRs) came recently into focus as promising novel research targets offering new insights into the pathogenesis of inflammatory bowel diseases (IBD). AIMS: The aim of our study was to identify a pediatric IBD (pIBD) characteristic miR profile serving as potential Crohn's disease (CD) and ulcerative colitis (UC) specific diagnostic pattern and to further analyze the related target genes. METHODS: Small RNA sequencing was performed on inflamed and intact colonic biopsies of CD, and control patients...
December 27, 2016: Digestive and Liver Disease
https://www.readbyqxmd.com/read/28058011/fecal-microbial-transplant-for-the-treatment-of-pediatric-inflammatory-bowel-disease
#4
REVIEW
Alice Yuxin Wang, Jelena Popov, Nikhil Pai
The role of fecal microbial transplant (FMT) in the treatment of pediatric gastrointestinal disease has become increasingly popular among pediatric practitioners, patients, and parents. The success of FMT for the treatment of recurrent Clostridium difficile infection (RCDI) has bolstered interest in its potential application to other disease states, such as inflammatory bowel disease (IBD). FMT has particular interest in pediatrics, given the concerns of patients and parents about rates of adverse events with existing therapeutic options, and the greater cumulative medication burden associated with childhood-onset disease...
December 21, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28045777/capillary-flow-rates-in-the-duodenum-of-pediatric-ulcerative-colitis-patients-are-increased-and-unrelated-to-inflammation
#5
Deenaz Zaidi, Lucas Churchill, Hien Q Huynh, Matthew W Carroll, Rabin Persad, Eytan Wine
BACKGROUND: Inflammatory bowel diseases (IBD), including Crohn disease (CD) and ulcerative colitis (UC), are chronic pediatric disorders. Changes in vasculature are described in IBD but these could be secondary to inflammation and the role in pathogenesis is poorly understood. Assessing circulatory changes in typically unaffected sites in IBD (e.g., duodenum), when inflammation is absent, can identify vascular changes associated with pathogenesis. AIM: To measure capillary flow rates in duodenal mucosa using probe-based confocal laser endomicroscopy (pCLE) during endoscopy in children with IBD...
December 30, 2016: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28045769/diverting-ileostomy-for-the-treatment-of-severe-refractory-pediatric-inflammatory-bowel-disease
#6
Elizabeth C Maxwell, Noor Dawany, Robert N Baldassano, Petar Mamula, Peter Mattei, Lindsey Albenberg, Judith R Kelsen
OBJECTIVES: Diverting ileostomy is used as a temporizing therapy in patients with perianal Crohn disease; however, little data exist regarding its use for colonic disease. The primary aim of the present study was to determine the role of diversion in severe refractory colonic inflammatory bowel disease (IBD) in a pediatric population. METHODS: Retrospective study of patients who underwent diverting ileostomy at The Children's Hospital of Philadelphia from 2000 to 2014 for the management of severe, refractory colonic IBD...
December 30, 2016: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28039159/gut-microbiota-differs-between-children-with-inflammatory-bowel-disease-and-healthy-siblings-in-taxonomic-and-functional-composition-a-metagenomic-analysis
#7
Rebecca Luise Knoll, Kristoffer Forslund, Jens Roat Kultima, Claudius U Meyer, Ulrike Kullmer, Shinichi Sunagawa, Peer Bork, Stephan Gehring
Current treatment for pediatric IBD patients is often ineffective, with serious side effects. Manipulating the gut microbiota via fecal microbiota transplantation (FMT) is an emerging treatment approach but remains controversial. We aimed to assess the composition of the fecal microbiome through a comparison of pediatric IBD patients to their healthy siblings, evaluating risks and prospects for FMT in this setting. A Case-Control (Sibling) Study was conducted analyzing fecal samples of six children with Crohn's Disease (CD), six children with Ulcerative Colitis (UC) and 12 healthy siblings by metagenomic sequencing...
December 30, 2016: American Journal of Physiology. Gastrointestinal and Liver Physiology
https://www.readbyqxmd.com/read/28030510/clinical-and-fecal-microbial-changes-with-diet-therapy-in-active-inflammatory-bowel-disease
#8
David L Suskind, Stanley A Cohen, Mitchell J Brittnacher, Ghassan Wahbeh, Dale Lee, Michele L Shaffer, Kimberly Braly, Hillary S Hayden, Jani Klein, Benjamin Gold, Matthew Giefer, Angela Stallworth, Samuel I Miller
GOAL: To determine the effect of the specific carbohydrate diet (SCD) on active inflammatory bowel disease (IBD). BACKGROUND: IBD is a chronic idiopathic inflammatory intestinal disorder associated with fecal dysbiosis. Diet is a potential therapeutic option for IBD based on the hypothesis that changing the fecal dysbiosis could decrease intestinal inflammation. STUDY: Pediatric patients with mild to moderate IBD defined by pediatric Crohn's disease activity index (PCDAI 10-45) or pediatric ulcerative colitis activity index (PUCAI 10-65) were enrolled into a prospective study of the SCD...
December 27, 2016: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28008999/genetic-architecture-differences-between-pediatric-and-adult-onset-inflammatory-bowel-diseases-in-the-polish-population
#9
Jerzy Ostrowski, Agnieszka Paziewska, Izabella Lazowska, Filip Ambrozkiewicz, Krzysztof Goryca, Maria Kulecka, Tomasz Rawa, Jakub Karczmarski, Michalina Dabrowska, Natalia Zeber-Lubecka, Roman Tomecki, Anna Kluska, Aneta Balabas, Magdalena Piatkowska, Katarzyna Paczkowska, Jaroslaw Kierkus, Piotr Socha, Michal Lodyga, Grazyna Rydzewska, Maria Klopocka, Grazyna Mierzwa, Barbara Iwanczak, Elzbieta Krzesiek, Katarzyna Bak-Drabik, Jaroslaw Walkowiak, Beata Klincewicz, Piotr Radwan, Urszula Grzybowska-Chlebowczyk, Piotr Landowski, Agnieszka Jankowska, Bartosz Korczowski, Teresa Starzynska, Piotr Albrecht, Michal Mikula
Most inflammatory bowel diseases (IBDs) are classic complex disorders represented by common alleles. Here we aimed to define the genetic architecture of pediatric and adult-onset IBDs for the Polish population. A total of 1495 patients were recruited, including 761 patients with Crohn's disease (CD; 424 pediatric), 734 patients with ulcerative colitis (UC; 390 pediatric), and 934 healthy controls. Allelotyping employed a pooled-DNA genome-wide association study (GWAS) and was validated by individual genotyping...
December 23, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27935231/prolonged-tacrolimus-use-for-pediatric-gastrointestinal-disorder-a-double-edged-sword
#10
Kenji Hosoi, Katsuhiro Arai, Kentaro Matsuoka, Hirotaka Shimizu, Koichi Kamei, Atsuko Nakazawa, Toshiaki Shimizu, Julian Tang, Shuichi Ito
BACKGROUND: Although tacrolimus (TAC) appeared useful in inducing remission in children with refractory inflammatory bowel disease (IBD) or autoimmune gastroenteropathy (AGE), its use in maintenance therapy remains controversial. The aim of this study was to reveal the potential nephrotoxic nature of prolonged TAC use. METHODS: This retrospective study reviews children with gastrointestinal disorder who underwent kidney biopsy for the evaluation of renal damage during TAC therapy of over one year...
December 9, 2016: Pediatrics International: Official Journal of the Japan Pediatric Society
https://www.readbyqxmd.com/read/27932194/associations-between-nod2-irgm-and-ormdl3-polymorphisms-and-pediatric-onset-inflammatory-bowel-disease-in-the-lithuanian-population
#11
Gitana Pranculienė, Rūta Steponaitienė, Jurgita Skiecevičienė, Rūta Kučinskienė, Gediminas Kiudelis, Kęstutis Adamonis, Liutauras Labanauskas, Limas Kupčinskas
BACKGROUND AND OBJECTIVE: Recent GWAS and meta-analyses have revealed about 200 susceptibility genes/loci for inflammatory bowel diseases (IBD). However, only a small number of studies were performed in early-onset IBD. The aim of this study was to assess the association between NOD2, IL23R, ATG16L1, IRGM, IL10, NKX2-3 and ORMDL3 variants and early-onset IBD. MATERIALS AND METHODS: A total of 76 affected individuals (30 with Crohn's disease [CD] and 46 with ulcerative colitis [UC]) at the age of ≤17 years and 158 matched controls recruited in Lithuania were genotyped for the known genetic susceptibility variants in NOD2 (Arg702Trp (rs2066844), Gly908Arg (rs2066845) and Leu1007insC (rs2066847)), IL23R (rs11209026), ATG16L1 (rs2241880), IRGM (rs4958847), IL10 (rs3024505), NKX2-3 (rs11190140) and ORMDL3 (rs2872507) genes...
2016: Medicina
https://www.readbyqxmd.com/read/27930380/vitamin-d-in-pediatric-gastrointestinal-disease
#12
Rajni Ahlawat, Toba Weinstein, Michael J Pettei
PURPOSE OF REVIEW: The purpose of this review is to examine the prevalence of vitamin D deficiency in pediatric gastrointestinal disease, specifically celiac disease and inflammatory bowel disease (IBD); to discuss the role of vitamin D and its deficiency in gastrointestinal disease pathophysiology; and to present current literature regarding diagnosis and treatment of vitamin D deficiency in these pediatric gastrointestinal diseases. RECENT FINDINGS: Vitamin D deficiency is common in children with gastrointestinal symptoms and disease processes...
December 7, 2016: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/27920643/elevated-lipase-during-initial-presentation-of-ulcerative-colitis-in-a-pediatric-patient-do-we-check-for-it
#13
Piyali Ray, Melissa R Van Arsdall
There are very few reports of elevated lipase in pediatric inflammatory bowel disease (IBD). Symptoms of pancreatitis may be masked by abdominal pain in pediatric IBD. During the initial presentation of IBD in our patient, lipase was elevated to more than 3 times the upper limit of normal. Normalization of values coincided with remission of IBD. This may be due to extraintestinal involvement of the pancreas as part of the inflammatory process or due to leakage of pancreatic enzymes from an inflamed gut or mediated by inflammatory cytokines...
September 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/27887202/serological-markers-in-diagnosis-of-pediatric-inflammatory-bowel-disease-and-as-predictors-for-early-tumor-necrosis-factor-blocker-therapy
#14
Christine Olbjørn, Milada Cvancarova Småstuen, Espen Thiis-Evensen, Britt Nakstad, Morten Harald Vatn, Gøri Perminow
OBJECTIVE: To describe the prevalence of serological markers in newly diagnosed treatment-naïve pediatric inflammatory bowel disease (IBD), their utility in differentiating Crohn's disease (CD), ulcerative colitis (UC) and symptomatic non-IBD patients and whether serological markers are associated with early TNF blocker treatment. MATERIAL AND METHODS: Ninety-six children and adolescents <18 years, 58 with IBD and 38 symptomatic non-IBD controls were included...
November 25, 2016: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/27882164/inflammatory-bowel-disease-in-chinese-children-a-retrospective-analysis-of-49-cases
#15
Ying Zhou, Ying Huang
To present study reports the clinical characteristics, diagnosis and management of pediatric patients with inflammatory bowel disease (IBD) in China. Clinical records of 49 pediatric patients with IBD at Fudan University Children's Hospital (Shanghai, China) between July 2001 and May 2012 were reviewed. Of 49 patients (30 males and 19 females), 8 patients had ulcerative colitis (UC) and 41 patients had Crohn's disease (CD). The mean age was 10.4 years in patients with UC and 10.1 years in patients with CD. The percentages of patients with UC with abdominal pain, diarrhea or rectal bleeding were 62...
November 2016: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/27875353/cannabinoid-receptor-2-functional-variant-contributes-to-the-risk-for-pediatric-inflammatory-bowel-disease
#16
Caterina Strisciuglio, Giulia Bellini, Erasmo Miele, Massimo Martinelli, Sabrina Cenni, Chiara Tortora, Carlo Tolone, Emanuele Miraglia Del Giudice, Francesca Rossi
GOALS: We conducted a case-control association analysis to establish the role of a common CB2 functional variant, Q63R, in the susceptibility to inflammatory bowel disease (IBD). BACKGROUND: Endocannabinoids may limit intestinal inflammation through cannabinoid receptor 1 and/or 2 (CB1, CB2). STUDY: We genotyped 217 pediatric IBD patients [112 Crohn's disease (CD), 105 ulcerative colitis (UC)] and 600 controls for the CB2-Q63R variant by Taqman assay...
November 21, 2016: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/27862714/de-novo-inflammatory-bowel-disease-after-pediatric-kidney-or-liver-transplant
#17
Melissa A Fernandes, Hillary J Braun, Kim Evason, Sue Rhee, Emily R Perito
A subset of children who receive a liver and/or kidney transplant develop de novo inflammatory bowel disease-like chronic intestinal inflammation, not explained by infection or medications, following transplant. We have conducted a single-center, retrospective case series describing the unique clinical and histologic features of this IBD-like chronic intestinal inflammation following solid organ transplant. At our center, nine of 327 kidney or liver recipients developed de novo IBD following transplant (six liver, two kidney, one liver-kidney)...
November 11, 2016: Pediatric Transplantation
https://www.readbyqxmd.com/read/27861181/genetic-risk-for-inflammatory-bowel-disease-is-a-determinant-of-crohn-s-disease-development-in-chronic-granulomatous-disease
#18
Chengrui Huang, Suk See De Ravin, Adam R Paul, Theo Heller, Nancy Ho, Lisa Wu Datta, Christa S Zerbe, Beatriz E Marciano, Douglas B Kuhns, Howard A Kader, Steven M Holland, Harry L Malech, Steven R Brant
BACKGROUND: Approximately, one-third to one-half of children with chronic granulomatous disease (CGD) develop gastrointestinal inflammation characteristic of idiopathic inflammatory bowel disease (IBD), usually Crohn's disease. We hypothesized that the overall IBD genetic risk, determined by IBD genetic risk score (GRS), might in part determine IBD development in CGD. METHODS: We reviewed medical records to establish IBD diagnoses in CGD subjects seen at NIAID. IBD risk single nucleotide polymorphism genotypes were determined using the Immunochip, and GRS were estimated by Mangrove...
December 2016: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/27855438/how-to-prevent-depression-current-directions-and-future-challenges-in-children-with-chronic-medical-conditions
#19
Anna Felnhofer, Oswald D Kothgassner, Claudia Klier
With its high rates of chronicity and concomitant economic costs to society, depression ranges among the most prevalent mental disorders. Several trials have succeeded in demonstrating the beneficial effects of early depression prevention programs for otherwise healthy children and adolescents. However, comparable programs for children and adolescents with a medical condition are still scarce. This paper discusses the situation of chronically ill children and adolescents who are at risk of developing comorbid depressive symptoms using the example of three conditions frequently encountered in pediatric psychosomatic medicine: diabetes, epilepsy and inflammatory bowel disease (IBD)...
December 2016: Psychiatria Danubina
https://www.readbyqxmd.com/read/27846066/prevalence-and-patterns-of-marijuana-use-in-young-adults-with-inflammatory-bowel-disease
#20
Uma Padhye Phatak, Danilo Rojas-Velasquez, Anthony Porto, Dinesh S Pashankar
OBJECTIVES: Recent studies in adults report symptom relief with marijuana use in patients with inflammatory bowel disease (IBD). We assessed the prevalence, pattern, effects and adverse effects of marijuana use in young adults with IBD. METHODS: We conducted a prospective questionnaire survey study at a pediatric IBD clinic. All patients (18 to 21 years of age) answered anonymous questionnaires about demographics, IBD, medications and marijuana use. RESULTS: Fifty-three patients (Mean age 18...
November 14, 2016: Journal of Pediatric Gastroenterology and Nutrition
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