Inflammatory bowel disease in children and adolescents in Italy: Data from the pediatric national IBD register (1996–2003)

Abstract

Background: The purpose was to assess in Italy the clinical features at diagnosis of inflammatory bowel disease (IBD) in children. Methods: In 1996 an IBD register of disease onset was established on a national scale. Results: Up to the end of 2003, 1576 cases of pediatric IBD were recorded: 810 (52%) ulcerative colitis (UC), 635 (40%) Crohn's disease (CD), and 131 (8%) indeterminate colitis (IC). In the period 1996–2003 an increase of IBD incidence from 0.89 to 1.39/105 inhabitants aged <18 years was observed. IBD was more frequent among children aged between 6 and 12 years (57%) but 20% of patients had onset of the disease under 6 years of age; 28 patients were <1 year of age. Overall, 11% had 1 or more family members with IBD. The mean interval between onset of symptoms and diagnosis was higher in CD (10.1 months) and IC (9 months) versus UC (5.8 months). Extended colitis was the most frequent form in UC and ileocolic involvement the most frequent in CD. Upper intestinal tract involvement was present in 11% of CD patients. IC locations were similar to those of UC. Bloody diarrhea and abdominal pain were the most frequent symptoms in UC and IC, and abdominal pain and diarrhea in CD. Extraintestinal symptoms were more frequent in CD than in UC. Conclusions The IBD incidence in children and adolescents in Italy shows an increasing trend for all 3 pathologies. UC diagnoses exceeded CD. (Inflamm Bowel Dis 2008)

Tumor necrosis factor-α downregulates intestinal NHE8 expression by reducing basal promoter activity

“…Diarrhea is commonly seen in patients with inflammatory bowel diseases (IBDs) (12,33) and animals injected with bacterial lipopolysaccharide (LPS) (27,31,45). The reduction of intestinal NaCl absorption in IBDs (33,36) and in chronic enteritis (44) suggested that decreased Na ϩ /H ϩ exchange activity in the inflamed intestinal mucosa may impair electrolyte absorption and contribute to diarrhea since NHEs are important players in intestinal NaCl absorption.…”

Uloga nacionalnog registra u zbrinjavanju djece oboljele od kroničnih upalnih bolesti crijeva

“…Procjenjuje se da je ukupna incidencija kroničnih upalnih bolesti crijeva u djece oko 7/100 000 (1), a učestalost je veća u razvijenim zemljama sjeverne polutke (9). Crohnova se bolest najčešće prezentira bolovima u trbuhu, a ulcerozni kolitis rektalnim krvarenjem i proljevom (10,11,12,13). Osim crijevnim, manifestiraju se i izvancrijevnim (ekstraintestinalnim) simptomima, koji se pri postavljanju dijagnoze nalaze u 6-20% oboljele djece (2,11,14,15).…”

“…Crohnova se bolest najčešće prezentira bolovima u trbuhu, a ulcerozni kolitis rektalnim krvarenjem i proljevom (10,11,12,13). Osim crijevnim, manifestiraju se i izvancrijevnim (ekstraintestinalnim) simptomima, koji se pri postavljanju dijagnoze nalaze u 6-20% oboljele djece (2,11,14,15). Najčešće je riječ o artralgiji, aftoznom stomatitisu i nešto rjeđe artritisu (11,(14)(15)(16).…”

“…Osim crijevnim, manifestiraju se i izvancrijevnim (ekstraintestinalnim) simptomima, koji se pri postavljanju dijagnoze nalaze u 6-20% oboljele djece (2,11,14,15). Najčešće je riječ o artralgiji, aftoznom stomatitisu i nešto rjeđe artritisu (11,(14)(15)(16). Najčešća kožna manifestacija, nodozni eritem, pojavljuje se češće u C rohnovoj bolesti (14,16), a bolesti jetre, sklerozirajući kolangitis i autoimuni hepatitis u ulceroznom kolitisu (11,(14)(15)(16).…”

“…Najčešće je riječ o artralgiji, aftoznom stomatitisu i nešto rjeđe artritisu (11,(14)(15)(16). Najčešća kožna manifestacija, nodozni eritem, pojavljuje se češće u C rohnovoj bolesti (14,16), a bolesti jetre, sklerozirajući kolangitis i autoimuni hepatitis u ulceroznom kolitisu (11,(14)(15)(16). Najznačajnija osobitost bolesti u dječjoj dobi je zastoj u rastu koji se može javiti kao prvi simptom, odnosno biti prisutan pri postavljanju dijagnoze, ali može nastati i kao posljedica dugotrajne bolesti i primijenjene terapije.…”