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Ulcerative colitis children

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
C Mantegazza, F Angiero, G V Zuccotti
Alterations of the oral cavity are common in children: 22% of children aged less than 4 years and 44% of those aged more than 12 develop dental erosion, 9-95% of children in Europe and in North America develop gingivitis, with adolescents showing a prevalence of more than 60% [Italian Ministry of Health, Guidelines 2013]. Alterations within the oral cavity can be the first sign of systemic diseases and may thus allow for an early diagnosis and treatment. In particular, being the oral cavity a part of the gastrointestinal system, oral alterations can be an expression of a gastrointestinal disease...
September 2016: European Journal of Paediatric Dentistry: Official Journal of European Academy of Paediatric Dentistry
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
Hideki Kumagai, Koji Yokoyama, Tomoyuki Imagawa, Shun Inoue, Janyerkye Tulyeu, Mamoru Tanaka, Takanori Yamagata
Fecal microbiota transplantation (FMT) is a treatment designed to correct gut dysbiosis by administration of feces from a healthy volunteer. It is still unclear whether FMT for children with ulcerative colitis (UC) is effective or hazardous. Here we describe a young patient to have received FMT for UC. A three-year-old girl was admitted to our hospital with severe active UC, and treated with aminosalicylates and various immunosuppressive drugs. As remission was not achieved, we decided to try FMT before colectomy...
September 2016: Pediatric Gastroenterology, Hepatology & Nutrition
B Siegmund, R Atreya, B Bokemeyer, W Kruis, J Mudter, C Sander, S Schreiber, W Reindl, S Zeissig, T Kucharzik
After the expiry date of the patent protection for Infliximab in 2013, the biosimilar CT‑P13 was approved for indications in Crohn's disease and ulcerative colitis in adults as well as in children. The approval has been based on two randomized clinical studies indicating equivalence for the biosimilar with regard to pharmacokinetics, efficacy, as well as side-effects. The clinical experience since, in addition to multiple non-randomized studies, indicate a comparable efficacy and immunogenicity of the Infliximab biosimilar CT-P13 in inflammatory bowel disease...
October 6, 2016: Zeitschrift Für Gastroenterologie
Dan Turner, Baruch Yerushalmi, Michal Kori, Efrat Broide, Yael Mozer-Glassberg, Ron Shaoul, Kaija-Leena Kolho, Eyal Shteyer, Hussein Shamaly, Oren Ledder, Shlomi Cohen, Sarit Peleg, Avi On, Arie Levine
BACKGROUND: Trials in adults suggested once-daily (QD) dosing of 5-ASA may be as or more effective as twice-daily (BID) dosing in ulcerative colitis (UC). In this induction of remission, investigator-blinded, randomized-controlled-trial we aimed to compare effectiveness and safety of once vs. twice daily mesalazine (Pentasa®), in paediatric UC. METHODS: Children, 4-18 years with a PUCAI ( Paediatric Ulcerative Colitis Activity Index) of 10-55 points at inclusion, were randomized in blocks of 6 with blinded allocation to QD or BID mesalamine using a weight-based dosing table...
October 3, 2016: Journal of Crohn's & Colitis
Ana Savić Mlakar, Iva Hojsak, Mladen Jergović, Valerija Vojvoda Parčina, Žarko Babić, Branko Troskot, Željko Mihaljević, Krešo Bendelja
OBJECTIVES: Ulcerative colitis (UC), a chronic inflammation of the colon, is often more severe in children than adults. Identification of altered expression of efflux transporters, cytokines and suppressor of cytokine signalling (SOCS) molecules in pediatric vs. adult patients could provide insight to the differential molecular patterns related to the age and disease pathology. METHODS: Mucosal samples from terminal ileum and colon in pediatric (9 UC-New; 4 UC-Remission) and adult (9 UC-New; 8 UC-Remission) patients were compared to healthy subjects (15 children and 10 adults) for mRNA expressions of several efflux transporters, cytokines and SOCS molecules...
September 12, 2016: Journal of Pediatric Gastroenterology and Nutrition
Kaija-Leena Kolho, Alberto Pessia, Tytti Jaakkola, Willem M de Vos, Vidya Velagapudi
BACKGROUND: Inflammatory bowel disease [IBD] is considered to result from the interplay between host and intestinal microbiota but its pathogenesis is incompletely understood. While IBD in adults has shown to be associated with marked changes in body fluid metabolomics, there are only few studies in children. Hence, this prospective study addressed the faecal and serum metabolomics in newly diagnosed paediatric IBD. METHODS: Paediatric patients with IBD undergoing diagnostic endoscopies and controls also with endoscopy but no signs of inflammation provided blood and stool samples in a tertiary care hospital...
September 8, 2016: Journal of Crohn's & Colitis
Tamir Miloh, Mitchell Shub, Ramon Montes, Kristy Ingebo, Gary Silber, Brad Pasternak
: Successful treatment of patients with inflammatory bowel disease (IBD) requires regular intake of medication. Non- adherence to treatment is associated with increased frequency of relapses, morbidity and cost. METHODS: Pediatric IBD patients taking oral medication and with access to text message (TM) services were included. Children were randomized by age, gender, medication administration responsibility (self vs parent) and disease activity (Pediatric Crohn Disease Activity Index (PCDAI) or Pediatric Ulcerative Colitis Activity Index (PUCAI)) into TM intervention and standard of care...
September 6, 2016: Journal of Pediatric Gastroenterology and Nutrition
Daniël R Hoekman, Kay Diederen, Bart G P Koot, Merit M Tabbers, Angelika Kindermann, Marc A Benninga
UNLABELLED: In adult inflammatory bowel disease (IBD) patients, there is a strong discrepancy between symptoms and biomarkers of inflammation. Data on pediatric IBD patients are conflicting. Therefore, we aimed to investigate the relationship between clinical symptoms and biomarkers of inflammation in pediatric IBD. Patients aged <18 years with previously diagnosed Crohn's disease (CD) or ulcerative colitis (UC) were included. Clinical disease activity was determined using the abbreviated Pediatric CD Activity Index (aPCDAI) or Pediatric UC Activity Index (PUCAI)...
October 2016: European Journal of Pediatrics
Jeffrey R Savarino, Jess L Kaplan, Harland S Winter, Christopher J Moran, Esther J Israel
Inflammatory Bowel Disease (IBD) is a chronic autoimmune inflammatory disease of the intestine which can lead to malnutrition, poor quality of life, and colon cancer.(1-4) Although there is no cure for the disease, clinical remission is the primary goal.(5) The Center for Inflammatory Bowel Disease at MassGeneral Hospital for Children (MGHfC) adopted a Previsit Planning (PVP) model to identify and discuss symptomatic patients prior to their appointments to identify specific issues that impact disease management...
2016: BMJ Quality Improvement Reports
Eric I Benchimol, Douglas G Manuel, Nassim Mojaverian, David R Mack, Geoffrey C Nguyen, Teresa To, Astrid Guttmann
BACKGROUND: Canada has amongst the highest incidence of inflammatory bowel disease (IBD) in the world, and the highest proportion of immigrants among G8 nations. We determined differences in prediagnosis delay, specialist care, health services use, and risk of surgery in immigrants with IBD. METHODS: All incident cases of IBD in children (1994-2009) and adults (1999-2009) were identified from population-based health administrative data in Ontario, Canada. Linked immigration data identified those who arrived to Ontario after 1985...
October 2016: Inflammatory Bowel Diseases
Lauri J Virta, Maiju M Saarinen, Kaija-Leena Kolho
BACKGROUND AND AIMS: The burden of inflammatory bowel disease (IBD) in health care is high. We conducted research on the temporal changes in the incidence of pediatric IBD (PIBD) using nationwide registry-based data in Finland. METHODS: All PIBD cases diagnosed at less than 20 years of age during 1987-2014 (in total, 5,415 patients) were retrieved from a database documenting reimbursements for drug costs. Incidence rates were calculated by dividing the number of annual new PIBD cases by the size of the pediatric population at risk during each calendar year...
August 23, 2016: Journal of Crohn's & Colitis
Rona L Levy, Miranda A L van Tilburg, Shelby L Langer, Joan M Romano, Lynn S Walker, Lloyd A Mancl, Tasha B Murphy, Robyn L Claar, Shara I Feld, Dennis L Christie, Bisher Abdullah, Melissa M DuPen, Kimberly S Swanson, Melissa D Baker, Susan A Stoner, William E Whitehead
BACKGROUND: Studies testing the efficacy of behavioral interventions to modify psychosocial sequelae of inflammatory bowel disease in children are limited. This report presents outcomes through a 6-month follow-up from a large randomized controlled trial testing the efficacy of a cognitive behavioral intervention for children with inflammatory bowel disease and their parents. METHODS: One hundred eighty-five children aged 8 to 17 years with a diagnosis of Crohn's disease or ulcerative colitis and their parents were randomized to one of two 3-session conditions: (1) a social learning and cognitive behavioral therapy condition or (2) an education support condition designed to control for time and attention...
September 2016: Inflammatory Bowel Diseases
Namita Singh, Shervin Rabizadeh, Jacqueline Jossen, Nanci Pittman, Morgan Check, Ghonche Hashemi, Becky L Phan, Jeffrey S Hyams, Marla C Dubinsky
BACKGROUND: Though vedolizumab has received regulatory approval for the treatment of Crohn's disease (CD) and ulcerative colitis (UC) in adults, there is increasing off-label use in children. AIMS: To describe the experience with vedolizumab in pediatric inflammatory bowel disease (IBD) patients at 3 tertiary IBD centers and examine predictors of remission. METHODS: A retrospective review identified pediatric IBD patients (age < 18 yrs) receiving vedolizumab...
September 2016: Inflammatory Bowel Diseases
Joseph J LaConti, Jean A Donet, Jeong Hee Cho-Vega, Daniel A Sussman, Dana Ascherman, Amar R Deshpande
Tumor necrosis factor-α (TNFα) inhibitor therapy has signified an important milestone in the fight against many rheumatological disorders and inflammatory bowel disease (IBD). Cutaneous adverse events caused by this class of medications are well known but relatively uncommon. Most reactions are mild and rarely warrant treatment withdrawal. Henoch-Schönlein purpura (HSP) is a disease with cutaneous vasculitis, arthritis, and gastrointestinal and renal involvement that is usually seen in children, though the worst complications are typically seen in adults...
2016: Case Reports in Rheumatology
Pamela L Valentino, Shanna Wiggins, Sarah Harney, Roshan Raza, Christine K Lee, Maureen M Jonas
OBJECTIVES: Data regarding pediatric PSC natural history are limited. We describe a large pediatric PSC cohort with longitudinal follow-up. METHODS: Records review of pediatric PSC patients diagnosed between 1984 and 2014. RESULTS: N = 120 (63% M) aged 1-21y (median 14y) at diagnosis. 27% (31/113) had ASC (autoimmune sclerosing cholangitis), 24% had exclusive small duct PSC, METAVIR stage was F3-F4 in 41%. 81% of PSC patients had IBD; most had ulcerative/indeterminate colitis (72/97), typically pancolitis (40/72)...
August 6, 2016: Journal of Pediatric Gastroenterology and Nutrition
Sana Syed, Subra Kugathasan, Archana Kumar, Jarod Prince, Bess T Schoen, Courtney McCracken, Thomas R Ziegler, Parminder S Suchdev
BACKGROUND: Iron deficiency and anemia affect up to 50-75% of inflammatory bowel disease (IBD) patients. Iron deficiency in IBD may be difficult to diagnose because of the effect of inflammation on iron status biomarkers. Thus, there is a need for better methods to accurately determine iron status in IBD. OBJECTIVE: To investigate the association of inflammation with hemoglobin content of reticulocytes (CHr) and the utility of CHr in comparison to standard iron biomarkers...
July 16, 2016: Journal of Pediatric Gastroenterology and Nutrition
Oriane Truffinet, Christine Martinez-Vinson, Emilie Guerriero, Jean-Pierre Hugot, Jérôme Viala
OBJECTIVES: Tacrolimus is an immunosuppressive agent that has been proposed in the treatment of severe ulcerative colitis. This study examined the effectiveness and safety of tacrolimus in treating refractory Crohn Disease (CD) colitis in children. METHODS: All children treated by oral tacrolimus for CD colitis at a tertiary pediatric center were included in the study. All patients were refractory to steroids and infliximab. Clinical response (decreased PCDAI >15 and PCDAI < 30) and remission (PCDAI <10) were monitored at 2, 4, 6, 12 and 24 months after induction...
July 16, 2016: Journal of Pediatric Gastroenterology and Nutrition
J Leslie Knod, Monica Holder, Alexander R Cortez, Bruno Martinez-Leo, Patricia Kern, Shehzad Saeed, Brad Warner, Belinda Dickie, Richard A Falcone, Daniel von Allmen, Jason S Frischer
PURPOSE: We aim to investigate the postoperative outcomes, bowel habits and quality of life (QoL) of younger pediatric ulcerative colitis (UC) patients following surgical intervention compared to an older pediatric population. METHODS: Medical records of UC patients after colectomy with ileoanal reconstruction (2002-2013) at our institution were reviewed. Patients/parents completed a QoL, bowel habits and disease course questionnaire. Surgical outcomes, bowel habits and QoL were reported comparing the younger (≤11years old, n=26) to older (>11years old, n=38) cohorts...
August 2016: Journal of Pediatric Surgery
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