Inflammatory Markers in Children with Newly Diagnosed Inflammatory Bowel Disease

Abstract

AIM: Various markers of inflammation are commonly utilised in the assessment of children with symptoms suggestive of Inflammatory Bowel Disease (IBD). The aim of this study was to outline the results of standard inflammatory markers in a large group of children at the time of diagnosis with IBD. METHODS:The results of four standard inflammatory markers (ESR, albumin, platelet count and CRP) measured in a cohort of children diagnosed with IBD over a ten year period were reviewed retrospectively. Baseline demographic data, nutritional status (weight and height), disease type and disease location were also recorded. RESULTS: Data was available for 206 children diagnosed with IBD: 146 were diagnosed with Crohn disease (CD), 30 with ulcerative colitis (UC) and 30 with IBD unclassified (IBDU). Children with CD had longer duration of symptoms, and weighed less with lower BMI than children in the other disease groups. Furthermore, albumin levels were lower and platelets counts higher in children with CD. All four of the tests were normal in 13% of children with CD and 36% of those with IBDU. Children with CD were more likely to have abnormalities in all four tests. CONCLUSIONS: Children with CD were more likely to have abnormal systemic inflammatory markers and to have multiple

Identification and diagnosis of Crohn disease and ulcerative colitis in children

“…However, these tests lack specificity. 23 Further, these serum markers may not be concordant and may be less useful in the setting of UC than in CD. Stool-based assessments typically provide more specific indications of gut inflammation.…”

Letter to the Editor Re: Serum Calprotectin in Adolescents With Inflammatory Bowel Disease

“…Data on best practices in children are limited and practice varies widely across the United States and even within the same pediatric institution (6). To bring uniformity to the diagnosis and treatment of pediatric AP, the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) and European Pancreas Club/ Hungarian Pancreatic Study Group (EPC/HPSG) published pediatric AP management recommendations (7,8). Given the effectiveness of evidence-based clinical guidelines to improve clinical care (9), several pediatric hospitals have independently developed center-specific pediatric AP-focused treatment algorithms and admission order sets.…”

“…Most products included teaching points for provider education. Admission order sets and treatment algorithms from the 4 institutions were harmonized with current NASPGHAN and EPC/HPSG recommendations (7,8), and where applicable, the American Gastroenterological Association AP guidelines (12). For broader consensus these were sent to all authors of the NASPGHAN Clinical Report on management of pediatric AP (7).…”

“…Admission order sets and treatment algorithms from the 4 institutions were harmonized with current NASPGHAN and EPC/HPSG recommendations (7,8), and where applicable, the American Gastroenterological Association AP guidelines (12). For broader consensus these were sent to all authors of the NASPGHAN Clinical Report on management of pediatric AP (7). There was broad excitement and consensus with the major tenets of the algorithm and order set, with no objections or major concerns from any of the authors.…”

“…Consequently, a serum marker would certainly have a role in IBD. Standard markers provide variable indications of disease activity (6,7). SC has high test utility in conditions such as juvenile arthritis (8), but does not appear to have the same benefits in IBD.…”