Endoscopy in Pediatric Inflammatory Bowel Disease

Oliva, Salvatore; Thomson, Mike; Ridder, Lissy de; Martín-de-Carpi, Javier; Biervliet, S. Van; Braegger, Christian; Dias, Jorge Amil; Kolaček, Sanja; Miele, Erasmo; Buderus, Stephan; Bronský, Jiří; Winter, Harland S.; Navas-López, Víctor Manuel; Assa, Amit; Chong, Sonny K. F.; Afzal, Nadeem; Smets, Françoise; Shaoul, Ron; Hussey, Séamus; Turner, Dan; Cucchiara, Salvatore

doi:10.1097/mpg.0000000000002092

Cited by 75 publications

(71 citation statements)

References 236 publications

(360 reference statements)

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“…However, a subset of patients with UGI tract inflammation were asymptomatic at initial presentation[8,9,10]. Therefore, ESPGHAN Revised Porto Criteria recommended that esophagogastroduodenoscopy (EGD) should be performed in all children at the initial evaluation of IBD with two or more biopsies obtained from each site irrespective of the UGI tract manifestations and endoscopic appearances[7,11].…”

Section: Clinical Perspectivementioning

confidence: 99%

Upper gastrointestinal tract involvement of pediatric inflammatory bowel disease: A pathological review

Abuquteish

Putra

2019

WJG

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Upper gastrointestinal (UGI) tract involvement of inflammatory bowel disease (IBD) is commonly seen in pediatric patients. Upper endoscopy is included in the routine workup of children with suspected IBD to enhance the diagnosis and management of these patients. Currently, childhood IBD is classified into ulcerative colitis (UC), atypical UC, Crohn’s disease (CD) and IBD unclassified. Histologic confirmation of UGI tract involvement, in particular the presence of epithelioid (non-caseating) granulomas, is helpful in confirming the diagnosis of IBD and its classification. Herein, we reviewed selected IBD-associated UGI tract manifestations in children. Lymphocytic esophagitis, seen predominantly in CD, is histologically characterized by increased intraepithelial lymphocytes (> 20 in one high-power field) in a background of mucosal injury with absence of granulocytes. Focally enhanced gastritis is a form of gastric inflammation in pediatric IBD marked by a focal lymphohistiocytic pit inflammation with or without granulocytes and plasma cells in a relatively normal background gastric mucosa. Duodenal inflammation seen in children with IBD includes cryptitis, villous flattening, increased intraepithelial lymphocytes, and lamina propria eosinophilia. Finally, epithelioid granulomas not associated with ruptured gland/crypt are a diagnostic feature of CD. The clinicopathologic correlation and differential diagnosis of each microscopic finding are discussed. Clinicians and pathologists should be cognizant of the utility and limitations of these histologic features.

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Section: Clinical Perspectivementioning

confidence: 99%

Upper gastrointestinal tract involvement of pediatric inflammatory bowel disease: A pathological review

Abuquteish

Putra

2019

WJG

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“…Consistent with this, we did not observe a significant correlation between disease activity and SES-CD. A position paper by the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition does not recommend correlating endoscopic scores and clinical symptoms in UC patients 34 . In accordance with this, there was no significant correlation between PUCAI and UCEIS in this study.…”

Section: Discussionmentioning

confidence: 99%

Serological cytokine signature in paediatric patients with inflammatory bowel disease impacts diagnosis

Tatsuki

Hatori

Nakazawa

et al. 2020

Sci Rep

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Endoscopy is a central tool for diagnosing and evaluating paediatric inflammatory bowel diseases (PIBD), but is too invasive to be frequently repeated in young children. Furthermore, it is challenging to distinguish Crohn’s disease (CD) from ulcerative colitis (UC) endoscopically. This study aimed to determine biomarkers useful for the diagnosis of PIBD. Cytokines, chemokines, and growth factors were quantified in the sera of 15 patients with CD or UC, at disease onset prior to treatment, and 26 age-matched controls. Correlation of cytokine levels with the paediatric CD activity index (PCDAI) and the paediatric UC activity index (PUCAI) was analysed. Interleukin (IL)-6, IL-13, IL-7, and vascular endothelial growth factor were higher in the CD group than in the UC group. The receiver operating characteristic curve analysis showed that IL-7 was a putative biomarker for distinguishing CD from UC (area under the curve: 0.94). Granulocyte–macrophage colony-stimulating factor was associated with PCDAI, and an IL-1 receptor antagonist, IL-6, and macrophage inflammatory protein-1β were associated with PUCAI. These findings indicate significant differences in cytokine signatures among patients with new-onset PIBD, which may improve accuracy in diagnosing PIBD.

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“…The following paragraph describes the SBCE video review process. It is crucial to point out that, as emphasized in several clinical guidelines 3 4 5 7 8 9 this is only one step of a complex diagnostic work-up. Before approaching any SBCE video, it is essential to be aware of clinical details about a patient, such as the duration of the clinical history, comorbidities, medications, and clinical presentation.…”

Section: Reading Capsule Endoscopy: When and Wherementioning

confidence: 99%

“…They differ in technical features and specifications such as size and weight, number and position of cameras, frame rate acquisition, and battery duration, as well as in several functions of proprietary reading software. In this editorial, we aim to provide general principles for SBCE reading, which are only partially addressed in recent technical reviews or guidelines 3 4 5 6 7 8 9 . We would also like to suggest tips and tricks to reduce common deficiencies in SBCE.…”

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confidence: 99%

How to read small bowel capsule endoscopy: a practical guide for everyday use

Rondonotti

Pennazio²,

Tóth

et al. 2020

Endosc Int Open

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Small bowel (SB) capsule endoscopy (SBCE) is often perceived by both patients and physicians as a "lightweight," noninvasive, comfortable procedure that is easily performed with little more than swallowing a pill and a glass of water. However, "easy to carry out" does not translate to ease of reading or interpretation. A SB capsule acquires thousands of images and generates a long video; however, clinically relevant findings are often seen in only a few frames. There is no way to direct or focus the camera, the capsule's lens cannot be cleaned or luminal debris removed, and perhaps most importantly, the capsule cannot take tissue samples. Therefore, the rate of missed lesions in the SB has been quoted as high as 10 % [1]. Despite various SB imaging modalities offering similar diagnostic yield (DY) and miss rates, SBCE is one of the few endoscopic procedures open to immense scrutiny, as the data recorded are readily accessible for further on-demand review. This may expose clinicians to additional litigation but conversely, also provides a unique learning platform for new generations of SBCE readers. This is certainly fertile ground for virtual artificial neural network (ANN) training systems and even artificial intelligence (AI) diagnosis [2]. Currently, several different SBCE platforms exist. They differ in technical features and specifications such as size and weight, number and position of cameras, frame rate acquisition, and battery duration, as well as in several functions of proprietary reading software. In this editorial, we aim to provide general principles for SBCE reading, which are only partially addressed in recent technical reviews or guidelines [3-9]. We would also like to suggest tips and tricks to reduce common deficiencies in SBCE.

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Endoscopy in Pediatric Inflammatory Bowel Disease

Cited by 75 publications

References 236 publications

Upper gastrointestinal tract involvement of pediatric inflammatory bowel disease: A pathological review

Upper gastrointestinal tract involvement of pediatric inflammatory bowel disease: A pathological review

Serological cytokine signature in paediatric patients with inflammatory bowel disease impacts diagnosis

How to read small bowel capsule endoscopy: a practical guide for everyday use

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