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Ulcerative colitis children

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
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
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
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
Marco Gasparetto, Vivien Wong-Spracklen, Franco Torrente, Kate Howell, Mary Brennan, Gabriele Noble-Jamieson, Robert Heuschkel, Matthias Zilbauer
The disease course of children with ulcerative colitis (UC) varies substantially. Published data on predictors of disease outcomes in children remains scarce. We validate clinical predictors of outcomes in 93 children with UC in a single centre (age range: 2-18 years, minimum follow-up: 18 months). We stratified children into 3 groups according to their disease course, i.e. 1 = mild (38/93, 40.9%), 2 = moderate (38/93, 40.9%), 3 = severe (17, 18.2%). Comparison of clinical and biochemical parameters was performed between groups using Chi-square, Mann-Whitney and log-rank tests...
February 23, 2018: Journal of Pediatric Gastroenterology and Nutrition
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
Cary G Sauer, Matthew S Loop, Suresh Venkateswaran, Vin Tangpricha, Thomas R Ziegler, Ashish Dhawan, Courtney McCall, Erin Bonkowski, David R Mack, Brendan Boyle, Anne M Griffiths, Neal S Leleiko, David J Keljo, James Markowitz, Susan S Baker, Joel Rosh, Robert N Baldassano, Sonia Davis, Shiven Patel, Jessie Wang, Alison Marquis, Krista L Spada, Subra Kugathasan, Thomas Walters, Jeffrey S Hyams, Lee A Denson
Background: Vitamin D regulates intestinal epithelial and immune functions, and vitamin D receptor deficiency increases the severity of murine colitis. Bioavailable 25-hydroxyvitamin D (25(OH)D) is available to target tissues and may be a driver of immune function. The aim is to evaluate the relationship of bioavailable 25(OH)D to the clinical expression of treatment naive pediatric ulcerative colitis (UC). Methods: The PROTECT (Predicting Response to Standardized Pediatric Colitis Therapy) study enrolled children ≤17 years newly diagnosed with UC...
February 15, 2018: Inflammatory Bowel Diseases
Markku Voutilainen, Nina Hutri-Kähönen, Päivi Tossavainen, Taina Sipponen, Niina Pitkänen, Tomi Laitinen, Eero Jokinen, Tapani Rönnemaa, Jorma S A Viikari, Olli T Raitakari, Markus Juonala
BACKGROUND AND AIMS: Several genetic and environmental risk factors have been linked to chronic inflammatory bowel disease (IBD). The incidence of IBD has significantly increased in developed countries during last decades. The aim of the present study was to examine childhood risk factors for subsequent IBD diagnosis in a longitudinal cohort study of children and adolescents. METHODS: A Finnish study population consisting of 3551 children and adolescents originally evaluated as part of the Cardiovascular Risk in Young Finns study in 1980...
January 31, 2018: Digestive and Liver Disease
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
Katherine Li, Richard Strauss, Jodie Ouahed, Daphne Chan, Shannon E Telesco, Dror S Shouval, James B Canavan, Carrie Brodmerkel, Scott B Snapper, Joshua R Friedman
BACKGROUND: Efficacy data from adult ulcerative colitis (UC) clinical trials are often extrapolated for pediatric prescribing. Consequently, it is important to understand similarities/differences in pediatric and adult UC. Pediatric UC tends to have more extensive disease at presentation, yet genetic studies have not detected pathways that distinguish the populations, and differences in mucosal gene expression between adult and pediatric UC are not well characterized. METHODS: Using colonic microarray data from a phase 3 trial of golimumab in adult UC (87 UC; 21 healthy), the GSE10616 pediatric dataset (10 UC; 11 healthy), and a phase 1B trial of golimumab in pediatric UC (n = 19), UC expression profiles were compared and unique genes were defined as those with significant changes (|FC|>2x, adjusted p < 0...
February 3, 2018: Journal of Pediatric Gastroenterology and Nutrition
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
Kwang Yeon Kim, Eun Joo Lee, Ju Whi Kim, Jin Soo Moon, Ju Young Jang, Hye Ran Yang, Jae Sung Ko
Purpose: Monogenic inflammatory bowel disease (IBD) patients do not respond to conventional therapy and are associated with a higher morbidity. We summarized the clinical characteristics of monogenic IBD patients and compared their clinical outcomes to that of non-monogenic IBD patients. Methods: We performed a retrospective cohort study of all children <18 years old who were diagnosed with IBD between 2005 and 2016. A total of 230 children were enrolled. Monogenic IBD was defined as a presentation age less than 6 years old with confirmation of a genetic disorder...
January 2018: Pediatric Gastroenterology, Hepatology & Nutrition
Andrzej Wędrychowicz, Przemysław Tomasik, Andrzej Zając, Krzysztof Fyderek
Introduction: Interleukin-1β (IL-1β), interleukin-1 receptor antagonist (IL-1ra) and interleukin-6 (IL-6) contribute to the pathogenesis of ulcerative colitis (UC). The aim of our study was to evaluate the serum and stool IL-1β, IL-1ra and IL-6 concentrations as potential prognostic factors in children with UC. Material and methods: Thirty-eight children with UC (20 active, 18 inactive) and 14 healthy controls were prospectively included in the study. IL-1β, IL-1ra and IL-6 concentrations were measured in serum and stool supernatants at inclusion to the study using ELISA immunoassays...
January 2018: Archives of Medical Science: AMS
Amanda Ricciuto, Jennifer Fish, Nicholas Carman, Thomas D Walters, Peter C Church, Bettina E Hansen, Eileen Crowley, Iram Siddiqui, Geoffrey C Nguyen, Binita M Kamath, Anne M Griffiths
BACKGROUND & AIMS: Approximately 75% of children with primary sclerosing cholangitis (PSC) also have inflammatory bowel disease (IBD). IBD in patients with PSC (PSC-IBD) often has a unique phenotype, including a mild clinical course, yet it is associated with an increased risk of colorectal cancer compared to colonic IBD without PSC. We investigated whether subclinical endoscopic and histologic inflammation could account for the increased risk of colorectal cancer in patients with PSC-IBD, and whether these patients have increased fecal levels of calprotectin, a marker of inflammation...
January 25, 2018: Clinical Gastroenterology and Hepatology
Mathew Philip, Philip Augustine, Varghese Thomas, G N Ramesh, K R Vinayakumar, T M Ramachandran, Ismail Siyad, Roy J Mukkada, R Sobhana Devi, Antony P Chettupuzha, Varghese A Jaison, M Ramesh, P Mahadevan, Abraham Koshy
BACKGROUND: Inflammatory bowel disease (IBD) is considered uncommon in Asia. The aim of this study was to document the demographic characteristics and clinical aspects of ulcerative colitis (UC) and Crohn's disease (CD) in Kerala, India. METHODS: A survey of IBD in Kerala was performed. All gastroenterologists in the region were invited. From May 2013 to October 2015, data were collected in a standardized pro-forma. RESULTS: Forty-seven doctors in 34 centers contributed data...
January 24, 2018: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
Alka Goyal, Andrew Yeh, Brian R Bush, Brian A Firek, Leah M Siebold, Matthew Brian Rogers, Adam D Kufen, Michael J Morowitz
Background: The role of fecal microbiota transplant (FMT) in the treatment of pediatric inflammatory bowel disease (IBD) is unknown. The aims of this study were to assess safety, clinical response, and gut microbiome alterations in children with Crohn's disease (CD), ulcerative colitis (UC), or indeterminate colitis (IC). Methods: In this open-label, single-center prospective trial, patients with IBD refractory to medical therapy underwent a single FMT by upper and lower endoscopy...
January 18, 2018: Inflammatory Bowel Diseases
Takashi Ohya, Masakatsu Yanagimachi, Kentaro Iwasawa, Shuichiro Umetsu, Tsuyoshi Sogo, Ayano Inui, Tomoo Fujisawa, Shuichi Ito
AIM: To screen primary immunodeficiency, Wiskott-Aldrich syndrome (WAS), and chronic granulomatous disease (CGD) among children with inflammatory bowel disease (IBD). METHODS: This was a single-center retrospective study. Eighteen children with IBD were investigated. We analyzed their expression of Wiskott-Aldrich syndrome protein (WASP) in lymphocytes and superoxide generation in phagocytes using flow cytometry. When the expression of WASP or superoxide generation was low or absent, we performed genetic analysis to determine the cause of this...
December 28, 2017: World Journal of Gastroenterology: WJG
Maria Pia Costa Santos, Catarina Gomes, Joana Torres
Familial aggregation in inflammatory bowel disease (IBD) has been established for several decades, reflecting shared genetic and environmental susceptibility. A positive family history remains the strongest recognizable risk factor for the development of IBD and is reported in around 8-12% of IBD patients. Crohn's disease shows a more frequent familial pattern than ulcerative colitis. The risk of developing IBD in first-degree relatives of an affected proband is increased 4- to 8-fold. The risk for twins and children born from couples who both have IBD is also substantially higher; a cumulative effect of the number of family members affected has been described, with the highest incidence being described for families with three or more affected members...
January 2018: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
Anne K Örtqvist, Cecilia Lundholm, Jonas Halfvarson, Jonas F Ludvigsson, Catarina Almqvist
OBJECTIVE: Earlier studies on antibiotics exposure and development of IBD (Crohn's disease (CD) and ulcerative colitis (UC)) may have been biased by familial factors and gastroenteritis. We aimed to estimate the association between antibiotics during pregnancy or infantile age and very early onset (VEO) IBD. DESIGN: In this cohort study of 827 239 children born in Sweden between 2006 and 2013, we examined the link between exposure to systemic antibiotics and VEO-IBD (diagnosis <6 years of age), using Cox proportional hazard regression models...
January 10, 2018: Gut
Marina Aloi, Matteo Bramuzzo, Serena Arrigo, Claudio Romano, Giulia D'Arcangelo, Doriana Lacorte, Simona Gatti, Maria Teresa Illiceto, Francesca Zucconi, Dario Dilillo, Giovanna Zuin, Daniela Knafelz, Alberto Ravelli, Salvatore Cucchiara, Patrizia Alvisi
OBJECTIVES: The aim of this study was to evaluate the effectiveness and safety of adalimumab (ADA) in children with ulcerative colitis (UC) previously treated with infliximab (IFX). METHODS: Retrospective study including children with UC from a national registry who received ADA therapy. The primary endpoint was the rate of corticosteroid (CS) free remission at week 52. Secondary outcomes were: the rate of sustained clinical remission, primary non-response and loss of response at weeks 12, 30, and 52 and rate of mucosal healing (MH) and side effects at week 52...
January 6, 2018: Journal of Pediatric Gastroenterology and Nutrition
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