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pediatric inflammatory bowel disease

Katarzyna Sznurkowska, Anton Żawrocki, Jacek Sznurkowski, Maciej Zieliński, Piotr Landowski, Katarzyna Plata-Nazar, Ewa Iżycka-Świeszewska, Piotr Trzonkowski, Agnieszka Szlagatys-Sidorkiewicz, Barbara Kamińska
BACKGROUND/AIMS: To determine the proportion of T-regulatory cells (CD4(+)CD25(high)FOXP3(+) cells) in peripheral blood and the number of FOXP3(+) cells in intestinal mucosa of children with inflammatory bowel disease (IBD), and to verify whether these parameters correlate with the activity of the disease. MATERIAL AND METHODS: 24 patients newly diagnosed for IBD were included in the study: ulcerative colitis (UC; n = 13) and Crohn's disease (CD; n = 11). Seventeen healthy controls (HC) and 16 patients with irritable bowel syndrome (IBS) served as a control group for peripheral and intestinal Tregs assessment, respectively...
October 19, 2016: Immunological Investigations
Francesca Palone, Roberta Vitali, Salvatore Cucchiara, Maurizio Mennini, Alessandro Armuzzi, Daniela Pugliese, Renata DʼIncà, Brigida Barberio, Laura Stronati
BACKGROUND: Fecal high mobility group box 1 (HMGB1) has been suggested to be a novel noninvasive biomarker of gut inflammation. We aimed to assess the reliability of fecal HMGB1, compared with fecal calprotectin (FC), in detecting intestinal inflammation in pediatric and adult patients with inflammatory bowel disease (IBD) and to evaluate the accuracy of HMGB1 in identifying patients with IBD in clinical and endoscopic remission who still have histologic features of inflammation. METHODS: Stool samples from 85 children with IBD (49 Crohn's disease [CD] and 36 ulcerative colitis [UC] and 119 adults [57 Crohn's disease and 62 ulcerative colitis]) were analyzed for the study...
October 13, 2016: Inflammatory Bowel Diseases
Firas Rinawi, Amit Assa, Corina Hartman, Yael Mozer Glassberg, Vered Nachmias Friedler, Yoram Rosenbach, Ari Silbermintz, Noam Zevit, Raanan Shamir
BACKGROUND: Data describing the incidence and the risk factors for surgical interventions in pediatric Crohn's disease (CD) is inconsistent. Our aim was to describe the rates of intestinal surgery and to identify associated risk factors in a large cohort of children with CD. METHODS: Medical charts of 482 children with CD from the Schneider Pediatric Inflammatory Bowel Disease cohort who were diagnosed between 1981 and 2013 were carefully reviewed retrospectively...
October 13, 2016: Inflammatory Bowel Diseases
James W Varni, Robert J Shulman, Mariella M Self, Shehzad A Saeed, Ashish S Patel, Samuel Nurko, Deborah A Neigut, Miguel Saps, James P Franciosi, Jolanda M Denham, George M Zacur, Chelsea Vaughan Dark, Cristiane B Bendo, John F Pohl
OBJECTIVES: To investigate the multidimensional gastrointestinal symptoms predictors of generic health-related quality of life (HRQOL) in pediatric patients with inflammatory bowel disease (IBD) from the perspectives of pediatric patients and parents. METHODS: The Pediatric Quality of Life Inventory (PedsQL) Gastrointestinal Symptoms Scales and PedsQL 4.0 Generic Core Scales were completed in a 9-site study by 260 families of patients with IBD. Gastrointestinal Symptoms Scales measuring stomach pain, food and drink limits, gas and bloating, constipation, blood in stool, and diarrhea were identified as clinically important symptom differentiators from healthy controls based on prior findings, and subsequently tested for bivariate and multivariate linear associations with overall HRQOL (Generic Core Scales)...
October 5, 2016: Journal of Pediatric Gastroenterology and Nutrition
Ellen A Lipstein, Daniel J Lovell, Lee A Denson, Sandra C Kim, Charles Spencer, Richard F Ittenbach, Maria T Britto
OBJECTIVES: To understand the association between parents' perceptions of the decision process and the decision outcomes in decisions about the use of biologics in pediatric chronic conditions. METHODS: We mailed surveys to parents of children with IBD (inflammatory bowel disease) or JIA (juvenile idiopathic arthritis) who had started treatment with biologics in the prior two years and were treated at either of 2 children's hospitals. The survey included measures of the decision process, including decision control and physician engagement, and decision outcomes, including conflict and regret...
September 30, 2016: Journal of Pediatric Gastroenterology and Nutrition
Tasuku Suzuki, Yoji Sasahara, Atsuo Kikuchi, Humihiko Kakuta, Toshihiko Kashiwabara, Takashi Ishige, Yoshiko Nakayama, Masanori Tanaka, Akihiro Hoshino, Hirokazu Kanegane, Daiki Abukawa, Shigeo Kure
PURPOSE: Pediatric inflammatory bowel disease (IBD) is a heterogeneous disorder caused by multiple factors. Although genetic and immunological analyses are required for a definitive diagnosis, no reports of a comprehensive genetic study of a Japanese population are available. METHODS: In total, 35 Japanese patients <16 years of age suffering from IBD, including 27 patients aged <6 years with very early-onset IBD, were enrolled in this multicenter study. Exome and targeted gene panel sequencing was performed for all patients...
October 17, 2016: Journal of Clinical Immunology
Yu Qi Qiao, Chen Wen Cai, Zhi Hua Ran
Inflammatory bowel disease (IBD) patients exhibit impaired control of the microbiome in the gut. "Dysbiosis" is commonly observed. A Western diet is a risk factor for the development of IBD but may have different effects on the gut microbiota in IBD and non-IBD individuals. Exclusive enteral nutrition (EEN) can induce remission in pediatric Crohn's disease (CD) with a decrease in gut microbiome diversity after EEN treatment. Although there are some theoretical benefits, the actual treatment effects of prebiotics and probiotics in IBD patients can vary...
October 15, 2016: Journal of Digestive Diseases
Arik Alper, Lucy Zhang, Dinesh S Pashankar
We aimed to examine correlation of erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) with diagnosis of inflammatory bowel disease (IBD) and with clinical, endoscopic, histological and radiographic disease activity during follow-up. We reviewed charts of 135 children with IBD and correlated their ESR and CRP values with disease activity in various encounters over 5 years. Normal ESR and CRP values were observed in up to 28% of children with Crohn's disease and 42% of children with ulcerative colitis at diagnosis respectively...
October 12, 2016: Journal of Pediatric Gastroenterology and Nutrition
A Schnabel, U Range, G Hahn, T Siepmann, R Berner, C M Hedrich
Historically, osteomyelitis was considered an infectious disorder. More recently, inflammatory mechanisms were recognized causing a significant proportion of pediatric osteomyelitis. This study was to compare characteristics of children with chronic non-bacterial (CNO) and bacterial osteomyelitis (BOM). A chart review of osteomyelitis patients from the departments of pediatrics, pediatric surgery, orthopedic surgery, and oral and maxillofacial surgery was conducted in a tertiary referral center, covering the years 2004-2014...
October 11, 2016: Rheumatology International
Zehour AlSabban, Peter Church, Rahim Moineddin, Oscar M Navarro, Mary-Louise Greer, Thomas Walters, Govind B Chavhan
PURPOSE: To determine interobserver agreement (IOA) and accuracy of conventional MR enterography (MRE), qualitative diffusion, and apparent diffusion coefficient (ADC) values for detecting clinically active inflammation. METHODS: MREs in 57 consecutive children with suspected inflammatory bowel disease were retrospectively reviewed. RESULTS: Substantial IOA for conventional MRE (kappa=0.65) and qualitative diffusion (kappa=0.64), but fair to good IOA for ADC, (intra-class coefficient=0...
September 28, 2016: Clinical Imaging
Jennifer J Schoch, Stanislav N Tolkachjov, Jonathan A Cappel, Lawrence E Gibson, Dawn Marie R Davis
BACKGROUND/OBJECTIVES: Pyoderma gangrenosum (PG) is a neutrophilic dermatosis rarely seen in children. Its features have not been well characterized in children. We sought to characterize the clinical features, etiologic associations, and treatment of PG in children younger than 18 years. METHODS: We performed a retrospective review of children younger than 18 years with PG at the Mayo Clinic from January 1976 to August 2013. RESULTS: Thirteen children with PG were identified (n = 8; 62% female)...
October 4, 2016: Pediatric Dermatology
Gautam Ray
There is rising incidence and prevalence of inflammatory bowel disease (IBD) in India topping the Southeast Asian (SEA) countries. The common genes implicated in disease pathogenesis in the West are not causal in Indian patients and the role of "hygiene hypothesis" is unclear. There appears to be a North-South divide with more ulcerative colitis (UC) in north and Crohn's disease (CD) in south India. IBD in second generation Indian migrants to the West takes the early onset and more severe form of the West whereas it retains the nature of its country of origin in migrants to SEA countries...
September 28, 2016: World Journal of Gastroenterology: WJG
George Giannakopoulos, George Chouliaras, Daphne Margoni, Sophia Korlou, Vassiliki Hantzara, Ioanna Panayotou, Eleftheria Roma, Magda Liakopoulou, Dimitris C Anagnostopoulos
AIM: To investigate the association of psychiatric and psychosocial correlates with inflammatory bowel disease (IBD) activity in children and adolescents. METHODS: A total of 85 pediatric IBD patients (in remission or active state of the disease) and their parents completed a series of questionnaires and semi-structured interviews measuring life events, depression, anxiety, family dysfunction, and parent mental health. Differences between the remission and the IBD active group and the association of any significant variable with the disease activity state were examined...
September 22, 2016: World Journal of Psychiatry
Chiara Rosso, Gian P Caviglia, Rinaldo Pellicano
Calprotectin is a heterodimeric protein which belongs to the calcium-binding protein S100 family. Calprotectin is released by leukocytes at the site of inflammation and it can be detected in the feces where it remains stable for about a week. Hence, increased fecal calprotectin (FC) levels are found in several inflammatory conditions, mainly the inflammatory bowel diseases (IBD). In the setting of pediatric gastroenterology, the importance of FC has increased over time. This review aims to summarize the most recent findings concerning the role of FC in the algorithm of different inflammatory and non-inflammatory conditions among pediatric patients...
December 2016: Minerva Pediatrica
Hyun Jin Kim, Seak Hee Oh, Dae Yeon Kim, Ho-Su Lee, Sang Hyoung Park, Suk-Kyun Yang, Kyung Mo Kim
BACKGROUND AND AIMS: Although paediatric Crohn's disease [CD] has a different phenotype and clinical course to adult CD, its clinical features and surgical risks are poorly defined, especially in Asian countries. The aim of this study was to investigate the clinical features and long-term outcomes of paediatric CD in a Korean population. METHODS: We retrospectively analysed 594 patients who were younger than 18 years of age at CD diagnosis between 1987 and 2013...
September 20, 2016: Journal of Crohn's & Colitis
Domenico Corica, Claudio Romano
The incidence of inflammatory bowel disease (IBD) has increased steadily worldwide, both in adult and in children; approximately 25% of IBD patients are diagnosed before the age of 18. The natural history of IBD is usually more severe in children than in adults, and can be associated with linear growth impairment, delayed puberty onset, reduced bone mass index, malnutrition, and the need for surgery. Biological therapies, especially blocking tumor necrosis factor-α (TNFα), have radically modified the treatment strategies and disease course of IBD in children...
September 15, 2016: Journal of Clinical Gastroenterology
Daphnée Michelet, Juliette Andreu-Gallien, Alia Skhiri, Arnaud Bonnard, Yves Nivoche, Souhayl Dahmani
BACKGROUND AND AIMS: Laparoscopic pediatric surgery allows a rapid postoperative rehabilitation and hospital discharge. However, the optimal postoperative pain management preserving advantages of this surgical technique remains to be determined. This study aimed to identify factors affecting the postoperative recovery of bowel function after laparoscopic surgery in children. MATERIAL AND METHODS: A retrospective analysis of factors affecting recovery of bowel function in children and infants undergoing laparoscopic surgery between January 1, 2009 and September 30, 2009, was performed...
July 2016: Journal of Anaesthesiology, Clinical Pharmacology
Mike Thomson, Andrea Tringali, Rosario Landi, Jean-Marc Dumonceau, Marta Tavares, Jorge Amil-Dias, Marc Benninga, Merit M Tabbers, Raoul Furlano, Manon Spaander, Cesare Hassan, Christos Tzvinikos, Hanneke Ijsselstijn, Jérôme Viala, Luigi Dall'Oglio, Rok Orel, Yvan Vandenplas, Radan Keil, Štěpán Hlava, Claudio Romano, Eva Brownstone, Patrick Gerner, Werner Dolak, Wolf Dietrich Huber, Simon Everett, Andreas Vecsei, Lars Aabakken, Alessandro Zambelli
This Guideline refers to infants, children and adolescents aged 0-18 years. The areas covered include: indications for diagnostic and therapeutic esophagogastroduodenoscopy and ileo-colonoscopy; endoscopy for foreign body ingestion; corrosive ingestion and stricture/stenosis endoscopic management; upper and lower gastrointestinal bleeding; endoscopic retrograde cholangio-pancreatography and endoscopic ultrasonography. Percutaneous endoscopic gastrostomy and endoscopy specific to inflammatory bowel disease (IBD) has been dealt with in other Guidelines [1-3] and are therefore not mentioned in this Guideline...
September 12, 2016: Journal of Pediatric Gastroenterology and Nutrition
Gea A Holtman, Yvonne Lisman-van Leeuwen, Boudewijn J Kollen, Obbe F Norbruis, Johanna C Escher, Angelika Kindermann, Yolanda B de Rijke, Patrick F van Rheenen, Marjolein Y Berger
PURPOSE: In specialist care, fecal calprotectin (FCal) is a commonly used noninvasive diagnostic test for ruling out inflammatory bowel disease (IBD) in children with chronic gastrointestinal symptoms. The aim of this study was to evaluate the diagnostic accuracy of FCal for IBD in symptomatic children in primary care. METHODS: We studied 2 prospective cohorts of children with chronic diarrhea, recurrent abdominal pain, or both: children initially seen in primary care (primary care cohort) and children referred to specialist care (referred cohort)...
September 2016: Annals of Family Medicine
Andrea Tringali, Mike Thomson, Jean-Marc Dumonceau, Marta Tavares, Merit M Tabbers, Raoul Furlano, Manon Spaander, Cesare Hassan, Christos Tzvinikos, Hanneke Ijsselstijn, Jérôme Viala, Luigi Dall'Oglio, Marc Benninga, Rok Orel, Yvan Vandenplas, Radan Keil, Claudio Romano, Eva Brownstone, Štěpán Hlava, Patrick Gerner, Werner Dolak, Rosario Landi, Wolf Dietrich Huber, Simon Everett, Andreas Vecsei, Lars Aabakken, Jorge Amil-Dias, Alessandro Zambelli
This Executive summary of the Guideline on pediatric gastrointestinal endoscopy from the European Society of Gastrointestinal Endoscopy (ESGE) and the European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) refers to infants, children, and adolescents aged 0 - 18 years. The areas covered include: indications for diagnostic and therapeutic esophagogastroduodenoscopy and ileocolonoscopy; endoscopy for foreign body ingestion; endoscopic management of corrosive ingestion and stricture/stenosis; upper and lower gastrointestinal bleeding; endoscopic retrograde cholangiopancreatography, and endoscopic ultrasonography...
September 12, 2016: Endoscopy
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