An assessment of the causes of lower gastrointestinal bleeding in a children’s hospital in northeastern Romania

Gimiga, Nicoleta; Burlea, Marin; Diaconescu, Smaranda; Olaru, Claudia

doi:10.2298/abs140917043g

Cited by 6 publications

(13 citation statements)

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“…A previous study showed that H. pylori infection accounted for 6% of children with duodenitis[8]. Moreover, Gimiga et al[9] found that gastritis and duodenitis contributed to half of children with upper gastrointestinal bleeding, and 36.89% of participants were diagnosed with H. pylori infection. These findings suggested a relatively high prevalence of children with H. pylori infection in the digestive system.…”

Section: Introductionmentioning

confidence: 99%

MiR-32-5p aggravates intestinal epithelial cell injury in pediatric enteritis induced by Helicobacter pylori

Feng¹,

Guo²,

Wang³

et al. 2019

WJG

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BACKGROUNDPediatric enteritis is one of the infectious diseases in the digestive system that causes a variety of digestive problems, including diarrhea, vomiting, and bellyache in children. Clinically, Helicobacter pylori (H. pylori) infection is one of the common factors to cause pediatric enteritis. It has been demonstrated that aberrant expression of microRNAs (miRNAs) is found in gastrointestinal diseases caused by H. pylori, and we discovered a significant increase of miR-32-5p in H. pylori-related pediatric enteritis. However, the exact role of miR-32-5p in it is still unknown.AIMTo investigate the role of aberrant miR-32-5p in pediatric enteritis induced by H. pylori.METHODSMiR-32-5p expression was detected by quantitative real time-polymerase chain reaction. The biological role of miR-32-5p in H. pylori-treated intestinal epithelial cells was evaluated by Cell Counting Kit-8 assay and flow cytometry. The potential target of miR-32-5p was predicted with TargetScanHuman and verified by luciferase assay. The downstream mechanism of miR-32-5p was explored by using molecular biology methods.RESULTSWe found that miR-32-5p was overexpressed in serum of H. pylori-induced pediatric enteritis. Further investigation revealed that H. pylori infection promoted the death of intestinal epithelial cells, and increased miR-32-5p expression. Moreover, miR-32-5p mimic further facilitated apoptosis and inflammatory cytokine secretion of intestinal epithelial cells. Further exploration revealed that SMAD family member 6 (SMAD6) was the direct target of miR-32-5p, and SMAD6 overexpression partially rescued cell damage induced by H. pylori. The following experiments showed that miR-32-5p/SMAD6 participated in the apoptosis of intestinal epithelial cells induced by transforming growth factor-β-activated kinase 1 (TAK1)-p38 activation under H. pylori infection.CONCLUSIONOur work uncovered the crucial role of aberrant expression of miR-32-5p in H. pylori–related pediatric enteritis, and suggested that the TAK1-p38 pathway is involved in it.

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Section: Introductionmentioning

confidence: 99%

MiR-32-5p aggravates intestinal epithelial cell injury in pediatric enteritis induced by Helicobacter pylori

Feng¹,

Guo²,

Wang³

et al. 2019

WJG

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“…GIE can reveal the underlying etiology of GIB in most cases[ 3 ]. However, it requires the experience and coordination of the medical team to provide specialized patient care[ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Causes of gastrointestinal bleeding in children based on endoscopic evaluation at a tertiary care center in Bahrain

Isa¹,

Alkharsi²,

Ebrahim³

et al. 2023

World J Gastrointest Endosc

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BACKGROUND Gastrointestinal bleeding (GIB) is a serious health problem worldwide, particularly during childhood. This can be an alarming sign of an underlying disease. Gastrointestinal endoscopy (GIE) is a safe method for the diagnosis and treatment of GIB in most cases. AIM To determine the incidence, clinical presentation, and outcomes of GIB in children in Bahrain over the last two decades. METHODS This was a retrospective cohort review of the medical records of children with GIB who underwent endoscopic procedures in the Pediatric Department at Salmaniya Medical Complex, Bahrain, between 1995 and 2022. Demographic data, clinical presentation, endoscopic findings, and clinical outcomes were recorded. GIB was classified into upper (UGIB) and lower (LGIB) GIB according to the site of bleeding. These were compared with respect to patients’ sex, age, and nationality using the Fisher’s exact, Pearson’s χ 2 , or the Mann-Whitney U tests. RESULTS A total of 250 patients were included in this study. The median incidence was 2.6/100000 per year (interquartile range, 1.4-3.7) with a significantly increasing trend over the last two decades ( P < 0.0001). Most patients were males ( n = 144, 57.6%). The median age at diagnosis was 9 years (5–11). Ninety-eight (39.2%) patients required upper GIE alone, 41 (16.4%) required colonoscopy alone, and 111 (44.4%) required both. LGIB was more frequent ( n = 151, 60.4%) than UGIB ( n = 119, 47.6%). There were no significant differences in sex ( P = 0.710), age ( P = 0.185), or nationality ( P = 0.525) between the two groups. Abnormal endoscopic findings were detected in 226 (90.4%) patients. The common cause of LGIB was inflammatory bowel disease (IBD) ( n = 77, 30.8%). The common cause of UGIB was gastritis ( n = 70, 28%). IBD and undetermined cause for bleeding were higher in the 10–18 years group ( P = 0.026 and P = 0.017, respectively). Intestinal nodular lymphoid hyperplasia, foreign body ingestion, and esophageal varices were more common in the 0–4 years group ( P = 0.034, P < 0.0001, and P = 0.029, respectively). Ten (4%) patients underwent one or more therapeutic interventions. The median follow-up period was two years (0.5-3). No mortality was reported in this study. CONCLUSION GIB in children is an alarming condition, whose significance is increasing. LGIB, commonly due to IBD, was more common than UGIB, commonly due to gastritis.

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“…The most frequent sources of hematemesis are varices and mucosal gastric and duodenal lesions, often caused by drug ingestion [1]. Moreover, a Romanian study performed on 103 children discovered that the most frequent cause of upper gastrointestinal bleeding was erosive gastritis, which accounted for a third of all cases [2]. According to Deerojanawong et al (2019) gastrointestinal bleeding is not uncommon among intensive care patients [3], with mechanically ventilated children being at risk of developing gastrointestinal hemorrhage [4].…”

Section: Introductionmentioning

confidence: 99%

“…In children, inadequate nutrition and drugs are cited as more common etiological factors [2,5], compared to adults, where gastrointestinal tumors represent a major cause of digestive bleedings.…”

Section: Introductionmentioning

confidence: 99%

Ibuprofen, a Potential Cause of Acute Hemorrhagic Gastritis in Children - A Case Report

Mărginean

Meliţ

Mocanu

et al. 2018

The Journal of Critical Care Medicine

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IntroductionUpper gastrointestinal bleeding is an uncommon but possible life-threatening entity in children, frequently caused by erosive gastritis. Non-steroidal anti-inflammatory drugs are one of the most common class of drugs which can cause gastrointestinal complications, including hemorrhagic gastritis.Case reportThe case of a 6-year-old male, admitted for hematemesis, abdominal pain and loss of appetite. It was ascertained at the time of admission, that ibuprofen had been prescribed as the patient had a fever. This was inappropriately administered as the mother did not respect the intervals between the doses.Initial laboratory tests revealed neutrophilia, leukopenia, high levels of lactate dehydrogenase and urea. An upper digestive endoscopy revealed an increased friability of the mucosa, digested blood in the gastric corpus and fornix. No active bleeding site was detected. The histopathological examination described a reactive modification of the corporeal gastric mucosa. Intravenous treatment with proton pump inhibitors and fluid replacement were initiated, with favorable results.ConclusionIbuprofen can lead to upper digestive hemorrhage independently of the administered dose. Parents should avoid administering Ibuprofen for fever suppression without consulting their pediatrician.

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An assessment of the causes of lower gastrointestinal bleeding in a children’s hospital in northeastern Romania

Cited by 6 publications

References 12 publications

MiR-32-5p aggravates intestinal epithelial cell injury in pediatric enteritis induced by Helicobacter pylori

MiR-32-5p aggravates intestinal epithelial cell injury in pediatric enteritis induced by Helicobacter pylori

Causes of gastrointestinal bleeding in children based on endoscopic evaluation at a tertiary care center in Bahrain

Ibuprofen, a Potential Cause of Acute Hemorrhagic Gastritis in Children - A Case Report

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