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(Children or kids or pediatric) crohn's

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
Michael D Kappelman, Aksel Lange, Rachel L Randell, Patricia V Basta, Robert S Sandler, Kristina Laugesen, Anna Byrjalsen, Tina Christensen, Trine Frøslev, Rune Erichsen
Background: Epidemiologic studies combining exposure and outcome data with the collection of biosamples are needed to study gene-environment interactions that might contribute to the etiology of complex diseases such as pediatric Crohn's disease (CD). Nationwide registries, including those in Denmark and other Scandinavian countries, provide efficient and reliable sources of data for epidemiological studies evaluating the environmental determinants of disease. We performed a pilot study to test the feasibility of collecting salivary DNA to augment registry data in established cases of pediatric CD and randomly selected, population-based controls...
2018: Clinical Epidemiology
Kristy L Rialon, Eileen Crowley, Natashia M Seemann, Aleixo Muise, Jacob C Langer
PURPOSE: The timing of J-pouch surgery following colectomy for children with very early-onset colitis is controversial, with some advocating early reconstruction and others delaying reconstruction because of fear that the colitis may be owing to Crohn's disease (CD). We sought to determine the long-term incidence of CD in this population and whether there may be clinical features that predict the risk of CD. METHODS: Children with noninfectious colitis diagnosed prior to age 10, who underwent subtotal colectomy and ileostomy from 2000 to 2015, were reviewed...
February 8, 2018: Journal of Pediatric Surgery
Artur Nemeth, Daniel Agardh, Gabriele Wurm Johansson, Henrik Thorlacius, Ervin Toth
Background: Video capsule endoscopy (VCE) is a noninvasive method enabling excellent visualization of the small bowel (SB) mucosa. The aim of this study was to examine the impact and safety of VCE performed in children and adolescents with suspected or established Crohn's disease (CD). Methods: A total of 180 VCE examinations in 169 consecutive patients conducted in 2003-14 in a single center were retrospectively analyzed. The median age was 13 years (range 3-17 years) and indications for VCE were suspected (125 cases, 69%) and established (55 cases, 31%) CD...
2018: Therapeutic Advances in Gastroenterology
You-Hong Fang, You-You Luo, Jin-Dan Yu, Jin-Gan Lou, Jie Chen
AIM: To analyze clinical differences between monogenic and nonmonogenic very-early-onset inflammatory bowel disease (VEO-IBD) and to characterize monogenic IBD phenotypically and genotypically via genetic testing. METHODS: A retrospective analysis of children aged 0 to 6 years diagnosed with VEO-IBD in a tertiary hospital in southern China from 2005 to 2017 was performed. Clinical data for VEO-IBD patients were collected, and genetic characteristics were analyzed using whole exome sequencing or target gene panel sequencing...
March 7, 2018: World Journal of Gastroenterology: WJG
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
Martina Blaschke, Regine Koepp, Julia Cortis, Marina Komrakova, Matthias Schieker, Ute Hempel, Heide Siggelkow
BACKGROUND: Crohn´s disease (CD) is associated with a higher prevalence of osteoporosis. The pathogenesis of bone affliction remains controversial, especially if inflammatory cytokines or glucocorticoid therapy are the main contributors. In postmenopausal osteoporosis, bone resorption is induced by IL-6, IL-1β and TNF-α. In contrast, in children with CD, IL-6 exclusively decreased bone formation without affecting bone resorption. OBJECTIVES: The objective of this study was to further clarify the pathophysiology of bone affliction in adult patients with CD with the use of an osteoblast and osteoclast cell model...
January 2018: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
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
Edouard J Louis, Walter Reinisch, David A Schwartz, Robert Löfberg, Anne M Robinson, Sofie Berg, Anthony W Wang, Jen-Fue Maa, Bidan Huang, Brandee Pappalardo
INTRODUCTION: Extraintestinal manifestations (EIMs) in patients with Crohn's disease (CD) are common and associated with additional morbidity. This study aimed to evaluate the effect of adalimumab therapy on EIM resolution and identify potential predictors of EIM resolution in adult and pediatric patients with moderate to severe CD. METHODS: EIM data were pooled from 11 induction, maintenance, and open-label extension studies of adalimumab. Resolution of EIMs was evaluated at approximately 6 months and 1 year...
March 7, 2018: Advances in Therapy
Inbar Nakar, Gili Focht, Peter Church, Thomas D Walters, Guila Abitbol, Sudha Anupindi, Laureline Berteloot, Jessie M Hulst, Frank Ruemmele, Daniel A Lemberg, Steven T Leach, Ruth Cytter, Mary-Louise Greer, Anne M Griffiths, Dan Turner
BACKGROUND & AIMS: Bowel healing is an important goal of therapy for patients with Crohn's disease (CD). Although there have been many studies of mucosal healing, transmural healing (in the bowel wall) has not been investigated in children. We analyzed data from the ImageKids study to determine associations among mucosal and transmural healing and levels of calprotectin and c-reactive protein in children with CD. METHODS: We collected data from a multi-center study designed to develop 2 magnetic resonance enterography (MRE)-based measures for children with CD (6-18 years old)...
March 1, 2018: Clinical Gastroenterology and Hepatology
Mikhail M Kostik, Evgeny N Suspitsin, Marina N Guseva, Anastasia S Levina, Anastasia Y Kazantseva, Anna P Sokolenko, Evgeny N Imyanitov
NLRP12-related autoinflammatory disease (NLRP12-AID) is an exceptionally rare autosomal dominant disorder caused by germline mutations in NLRP12 gene. Very few patients with NLRP12-AD have been identified worldwide; therefore, there is a scarcity of data on phenotypic presentation of this syndrome. Here we provide evidence that NLRP12-AID may have clinical manifestations characteristic for primary immune deficiencies (PID). 246 children with periodic fever (PF) of unknown origin were subjects to the next generation sequencing (NGS) analysis; 213 of these patients had signs of primary immunodeficiency (PID) manifested by recurrent infections, while 33 kids had isolated PF...
March 2, 2018: Rheumatology International
Stojanović Predrag, Kocić Branislava, Stojanović Nikola, Radulovic Niko, Stojanović-Radić Zorica, Dobrila Stanković-Đorđević
Carriage of Clostridium (C.) difficile in the intestinum of children, as well as its role in the disease (diarrhea) onset, is still controversial. The aim of this study is to investigate the community-acquired Clostridium difficile infection (CA-CDI) in Serbian pediatric population and to describe the basic clinical characteristics and risk factors for CA-CDI occurrence in Serbian pediatric population. The data obtained from 63 Serbian pediatric patients with CA-CDI and from control group of 126 children with community-acquired diarrhea, whose stool specimens were negative for C...
March 1, 2018: European Journal of Clinical Microbiology & Infectious Diseases
Daniel von Allmen
The incidence of Crohn's disease in the pediatric population is increasing. While pediatric patients with Crohn's disease exhibit many of the characteristics of older patients, there are important differences in the clinical presentation and course of disease that can impact the clinical decisions made during treatment. The majority of children are diagnosed in the early teen years, but subgroups of very early onset and infantile Crohn's present much earlier and have a unique clinical course. Treatment paradigms follow the traditional laddered approach, but growth and development represent special considerations that must be given to pediatric-specific complications of the treatment and disease...
March 2018: Clinics in Colon and Rectal Surgery
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
Basavaraj Kerur, Jason T Machan, Jason M Shapiro, Carolina S Cerezo, James Markowitz, David R Mack, Anne M Griffiths, Anthony R Otley, Marian D Pfefferkorn, Joel R Rosh, David J Keljo, Brendan Boyle, Maria Oliva-Hemker, Marsha H Kay, Shehzad A Saeed, Andrew B Grossman, Boris Sudel, Michael D Kappelman, Marc Schaefer, Gitit Tomer, Athos Bousvaros, Trudy Lerer, Jeffrey S Hyams, Neal S LeLeiko
BACKGROUND & AIMS: Up to 30% of patients with Crohn's disease (CD) require surgery within the first 5 years from diagnosis. We investigated the recent risk of bowel surgery in an inception cohort of pediatric patients with CD and whether early use of biologics (tumor necrosis factor antagonists) alters later disease course. METHODS: We collected data from the Pediatric Inflammatory Bowel Disease Collaborative Research Group registry on 1442 children (16 years old or younger) diagnosed with CD from January 2002 through December 2014...
February 24, 2018: Clinical Gastroenterology and Hepatology
J Ling, D Buurman, M Ravikumara, C Mews, K Thacker, Z Grover
BACKGROUND: Earlier introduction of infliximab (IFX) in Crohn's disease (CD) may be associated with a sustained remission. METHODS AND AIMS: Children on scheduled IFX therapy for predominant luminal CD after successful induction (drop in PCDAI by ≥ 15) and a minimum of 2-year IFX follow-up were included. We compared outcomes of children treated with early (within 3 months from diagnosis) versus later IFX (after failing conventional therapy ≥ 3 months) and identify clinical predictors of sustained primary response (SPR) in our cohort...
February 26, 2018: Digestive Diseases and Sciences
Federica Gigliucci, F A Bastiaan von Meijenfeldt, Arnold Knijn, Valeria Michelacci, Gaia Scavia, Fabio Minelli, Bas E Dutilh, Hamideh M Ahmad, Gerwin C Raangs, Alex W Friedrich, John W A Rossen, Stefano Morabito
The human intestinal microbiota is a homeostatic ecosystem with a remarkable impact on human health and the disruption of this equilibrium leads to an increased susceptibility to infection by numerous pathogens. In this study, we used shotgun metagenomic sequencing and two different bioinformatic approaches, based on mapping of the reads onto databases and on the reconstruction of putative draft genomes, to investigate possible changes in the composition of the intestinal microbiota in samples from patients with Shiga Toxin-producing E...
2018: Frontiers in Cellular and Infection Microbiology
Edward L Barnes, Michael D Kappelman
The significant increase in pediatric-onset inflammatory bowel disease in recent decades appears to be a global phenomenon, with studies from multiple geographic areas noting an increase in Crohn's disease (CD) and ulcerative colitis (UC). In this large, population-based cohort from northern France, the rapid increase in pediatric CD and UC from 1988-2011 may be due to multiple potential etiologies including environmental factors and advancements in diagnostic capabilities. We should consider the clinical implications of this rise in incidence, including potential risk stratification approaches that may offer the ability to modify the disease course of patients with earlier diagnosis...
February 2018: American Journal of Gastroenterology
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
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