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Crohn's children

Stephen J Walker, Daniel P Beavers, John Fortunato, Arthur Krigsman
Gastrointestinal symptoms are common in children with autism spectrum disorder (ASD). A significant proportion of children with ASD and gastrointestinal symptoms have histologic evidence of ileocolitis (inflammation of the terminal ileum and/or colon). We previously reported the molecular characterization of gastrointestinal biopsy tissue from ASD children with ileocolitis (ASD(IC+)) compared to anatomically similar inflamed tissue from typically developing children with inflammatory bowel disease (IBD; i.e...
October 21, 2016: Scientific Reports
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
Phillip Minar, Kimberly Jackson, Yi-Ting Tsai, Michael J Rosen, Michael Northcutt, Marat Khodoun, Fred D Finkelman, Lee A Denson
BACKGROUND: We have previously shown that CD64 surface expression on circulating neutrophils is significantly elevated in children with newly diagnosed Crohn's disease (CD). Our primary aim was to investigate whether elevations in neutrophil CD64 in asymptomatic patients could be used to predict treatment failure during maintenance infliximab. METHODS: Pediatric CD subjects receiving maintenance infliximab in clinical remission (short pediatric CD activity index [shPCDAI] <15) were enrolled...
November 2016: Inflammatory Bowel Diseases
Dana Duricova, Mathurin Fumery, Vito Annese, Peter L Lakatos, Laurent Peyrin-Biroulet, Corinne Gower-Rousseau
The incidence of Crohn's disease (CD) has been reported to increase. The aim of this review is to perform a comprehensive literature search of population-based studies focused on the natural history of paediatric-onset CD. A literature search of English and non-English language publications listed in the electronic database of MEDLINE (source PUBMED) and EMBASE from 1935 to 2016 was performed. Population-based studies or national cohorts reporting data on the short-term or long-term disease course of paediatric CD were included...
September 29, 2016: European Journal of Gastroenterology & Hepatology
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
Edyta Szymanska, Maciej Dadalski, Sylwia Szymanska, Wieslawa Grajkowska, Maciej Pronicki, Jaroslaw Kierkus
INTRODUCTION: The clinical efficacy of infliximab (IFX) for induction of remission in both adults and children with active Crohn's disease (CD) has been well documented. Recently, so-called "deep remission" defined as mucosal healing has become the ultimate endpoint of the most recent therapeutic advances for CD. However, endoscopic evidence of mucosal healing is not necessarily associated with histological evidence of suppression of inflammation. AIM: Since data on that issue are limited, especially in the paediatric population, the aim of this study was to assess the impact of induction therapy with IFX on deep microscopic remission in paediatric patients with CD...
2016: Przegla̜d Gastroenterologiczny
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
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
Natashia M Seemann, Sebastian K King, Abdul Elkadri, Thomas Walters, Joel Fish, Jacob C Langer
BACKGROUND/PURPOSE: Perianal Crohn's disease (PCD) can affect both quality of life and psychological wellbeing. A subset of pediatric patients with complex PCD require surgical intervention, although appropriate timing and treatment regimens remain unclear. This study aimed to describe a large pediatric cohort in a tertiary center to determine the range of surgical management in children with complex PCD. METHODS: A retrospective review of children requiring operative intervention for PCD over 13 years (2002-2014) was performed...
September 15, 2016: Journal of Pediatric Surgery
Daniel G Rosenbaum, Maire A Conrad, David M Biko, Eduardo D Ruchelli, Judith R Kelsen, Sudha A Anupindi
BACKGROUND: Imaging predictors for surgery in children with Crohn disease are lacking. OBJECTIVE: To identify imaging features of the terminal ileum on short-interval bowel ultrasound (US) and MR enterography (MRE) in children with Crohn disease requiring surgical bowel resection and those managed by medical therapy alone. MATERIALS AND METHODS: This retrospective study evaluated patients 18 years and younger with Crohn disease undergoing short-interval bowel US and MRE (within 2 months of one another), as well as subsequent ileocecectomy or endoscopy within 3 months of imaging...
September 29, 2016: Pediatric Radiology
Mikhail Lisovsky, Maria Westerhoff, Xuchen Zhang
The clinical significance of lymphocytic esophagitis (LyE), which is characterized by the prominence of peripapillary intraepithelial lymphocytes (IELs) without significant granulocytosis, remains poorly understood. During the last few years, plausible clinical correlates and novel approaches for stratification of LyE have started to emerge. Association with Crohn's disease has been established in children, but is not observed in adults. In adults, the form of LyE showing CD4(+) -predominant IELs has been recently found to be associated with non-achalasia primary motility abnormalities...
September 16, 2016: Annals of the New York Academy of Sciences
Barbara M Iwańczak, Józef Ryżko, Piotr Jankowski, Małgorzata Sładek, Agata Wasilewska, Mariusz Szczepanik, Edyta Sienkiewicz, Anna Szaflarska-Popławska, Sabina Więcek, Jarosław Kwiecień, Bartosz Korczowski, Jolanta Maślana
BACKGROUND: Infliximab is a biological drug used for the treatment of Crohn's disease in children. OBJECTIVES: The aim of this retrospective study was the estimation of effectiveness and safety of infliximab in the treatment of Crohn's disease with perianal fistulas in children. MATERIAL AND METHODS: Analysis comprised 50 children with Crohn's disease with perianal fistulas aged 9 to 18 years (16 girls and 34 boys) who failed to respond to conventional therapy...
May 2016: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
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
Máire A Conrad, Ronen E Stein, Elizabeth C Maxwell, Lindsey Albenberg, Robert N Baldassano, Noor Dawany, Andrew B Grossman, Petar Mamula, David A Piccoli, Judith R Kelsen
BACKGROUND: Vedolizumab is effective for inducing and maintaining remission in adults with inflammatory bowel disease (IBD); however, there is limited pediatric data. This study aimed to describe the adverse events and clinical response to vedolizumab in refractory pediatric IBD. METHODS: Disease activity indices, clinical response, concomitant medication use, and adverse events were measured over 22 weeks in an observational prospective cohort study of children with refractory IBD who had failed anti-tumor necrosis factor therapy and subsequently initiated vedolizumab therapy...
October 2016: Inflammatory Bowel Diseases
Fortunata Civitelli, Federica Nuti, Salvatore Oliva, Lorena Messina, Giuseppe La Torre, Franca Viola, Salvatore Cucchiara, Marina Aloi
BACKGROUND: Crohn's disease is a chronic inflammatory disease characterized by a progressive transmural bowel damage leading to complications. Anti-TNFα therapy is effective in achieving mucosal healing (MH), but its efficacy on transmural inflammation has been poorly investigated. The aim of this study is to evaluate, in pediatric Crohn's disease, the efficacy of anti-tumor necrosis factor α agents in inducing transmural healing (TH) as assessed by ultrasonography (US). METHODS: Children with Crohn's disease requiring anti-tumor necrosis factor α therapy were prospectively enrolled...
October 2016: Inflammatory Bowel Diseases
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
Wendy K M Liew, Christina A Pacak, Nicole Visyak, Basil T Darras, Athos Bousvaros, Peter B Kang
OBJECTIVE: To characterize the longitudinal clinical and electrophysiological patterns of thalidomide neuropathy in children and adolescents. STUDY DESIGN: Retrospective analysis of clinical records at a tertiary care children's hospital, including serial electrophysiological studies. RESULTS: Sixteen patients aged 6-24 years received thalidomide to treat Crohn's disease from 2002 to 2012. Nine subjects had electrophysiological evidence of sensorimotor axonal polyneuropathy, 8 of whom had sensory and/or motor symptoms...
August 24, 2016: Journal of Pediatrics
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