Juvenile Polyps in Bangladeshi Children and Their Association with Fecal Calprotectin as a Biomarker

Das, Subarna Rani; Karim, Asm Bazlul; Rukunuzzaman, M; Mazumder, Md Wahiduzzaman; Alam, Rafiqul; Benzamin, Md.; Marjan, Parisa; Sarker, Mst Naznin; Akther, H; Mondal, Mohuya

doi:10.5223/pghn.2022.25.1.52

Cited by 8 publications

(6 citation statements)

References 30 publications

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“…Exfoliation of cells into the stool would be expected to result in increased levels of fecal inflammatory markers. [14] The report by Das et al that colonic JPs are associated with increased FC that normalizes after polypectomy [12] is echoed in the present case, in which FC normalized after JP resection. FC measurement could therefore be recommended as a noninvasive screening biomarker (instead of frequent colonoscopies) to detect the presence of polyps and polyp recurrence.…”

Section: Discussionsupporting

confidence: 64%

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Fecal calprotectin measurement to detect recurrence of solitary juvenile polyps: A case report

Kudoh,

Kakiuchi,

Yoshiura

et al. 2023

Medicine

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Rationale: Juvenile polyps (JPs) are the most common polyp type and can be observed in 1% of all preschoolers. The peak incidence is observed at ages 3 to 5 years, constituting 90% of all polyps in children. Elevated levels of fecal calprotectin (FC) are often seen in children with JPs. Patient concerns: A 15-month-old girl was referred to our hospital for blood on the stool surface persisting for 3 months. She was healthy, with no abdominal pain, diarrhea, anorexia, or weight loss and no complaints other than hematochezia. Her physical examination, vital signs and laboratory date were unremarkable. Diagnosis: JPs Intervention: Total colonoscopy for her found 2 JPs in the sigmoid colon, which were subsequently resected endoscopically. Outcomes: At the age of 5 years, this patient again had bloody stools. Her FC measurement at that time was 1020 mg/kg, which normalized to 42 mg/kg 3 months after her second resection. Lessons: Single or multiple solitary JPs require follow-up that fully considers the possibility of recurrence. Establishing a method for early confirmation of JP recurrence based on bloody stools, fecal occult blood testing, and FC measurement is necessary.

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Section: Discussionsupporting

confidence: 64%

“…The utility of elevated FC as a diagnostic aid has been reported in colonic JPs. [ 12 , 13 ] JPs are composed of inflammatory cells, including many neutrophils, and the mucosal surface is often very friable. Exfoliation of cells into the stool would be expected to result in increased levels of fecal inflammatory markers.…”

Section: Discussionmentioning

confidence: 99%

Fecal calprotectin measurement to detect recurrence of solitary juvenile polyps: A case report

Kudoh,

Kakiuchi,

Yoshiura

et al. 2023

Medicine

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“…Another study showed that colonic JPs were associated with elevated levels of fecal calprotectin which normalized after polypectomy. 18 It would be fascinating to know the location of a polyp before conducting a colonoscopy. Moreover, this could possibly affect the currently recommended practice of conducting a full colonoscopy when polyps are suspected.…”

Section: Discussionmentioning

confidence: 99%

Associations of Polyp Characteristics in Children and Adolescents Presenting with Less Than Five Colorectal Polyps: A Full Colonoscopy Is Still Required

Kim

Choi

et al. 2022

Gut and Liver

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Background/Aims: A full colonoscopy is currently required in children and adolescents with colorectal polyps, because of their potential of neoplastic transformation and complications such as intussusception. We aimed to analyze the associations of polyp characteristics in children and adolescents with colorectal polyps. Based on these findings, we also aimed to reevaluate the necessity of conducting a full colonoscopy.Methods: Pediatric patients <18 years of age who had undergone a colonoscopic polypectomy and those with <5 colorectal polyps were included in this multicenter, retrospective study. Baseline clinicodemographics, colonoscopic and histologic findings were investigated.Results: A total of 91 patients were included. Multivariate logistic regression analysis showed that polyp size was the only factor associated with the presence of any polyps located proximal to the splenic flexure (odds ratio [OR], 2.25; 95% confidence interval [CI], 1.28 to 4.28; p=0.007). Furthermore, polyp location proximal to the splenic flexure and sessile morphology were associated with the presence of any adenomatous polyp (OR, 8.51; 95% CI, 1.43 to 68.65; p=0.023; OR, 18.41; 95% CI, 3.45 to 173.81; p=0.002, respectively). Conclusions:In children and adolescents presenting with <5 colorectal polyps, polyp size and the presence of any adenomatous polyp were positively associated with polyp location proximal to the splenic flexure. This finding supports the necessity of a full colonoscopic exam in pediatric patients with colorectal polyps for the detection of polyps before the occurrence of complications such as intussusception or neoplastic transformation.

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“…Multiple polyps in children who underwent a polypectomy colonoscopy were 20% to 50% [7,8], polyps near the sigmoid colon were 10%-50% [9,10] and 3%-15% in the right colon [11,12]. Many juvenile polyps in children, particularly with JPS, are at risk of developing adenomatous changes or even carcinomas in 26%-47% polyp's cases [13,14].…”

Section: Introductionmentioning

confidence: 99%

Clinical, Endoscopic and Pathological Characteristics of Colorectal Polyps in Children and Adolescents

Huq¹,

Saeed²,

Akhtar³

et al. 2023

PJMHS

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Background and Aim: Polyps of the gastrointestinal tract (GI) are apparent protrusions from the mucosal surface. The majority of polyps is asymptomatic and goes unnoticed; however in symptomatic situations, the most common clinical manifestations include abdominal discomfort, and rectal prolapse, intestinal blockage, and GI bleeding. The present study intended to assess the colorectal polyps characteristics based on clinical, pathological, and endoscopy in children and adolescents. Patients and Methods: This retrospective study was conducted on 78 children and adolescents (<18 years) with colorectal polyps in Gastroenterology Department of DHQ Teaching Hospital and Mufti Mahmood Memorial Hospital, Dera Ismail Khan from January 2020 to September 2022. Participants were assessed for various clinical variables such as age, gender, colonoscopy-related signs and symptoms, polyp identification, symptom’s onset age, duration between colonic polyp’s endoscopic diagnosis and symptoms onset, and intestinal polyps family history. Polyp’s characteristics involved: frequency, histology, morphological type, and distribution. SPSS version 26 was used for data analysis. Results: The overall mean age was 8.6±2.4 years with an age range 3 to 18 years. Of the total 78 colonic polyps, there were 48 (61.5%) male and 30 (38.5%) females. The most prevalent symptom was rectal bleeding present in 94.6% (n=74) cases with 13.8±16 months. Juvenile was the prevalent polyps found in 76.9% (n=60), out of which 96.7% (n=58) were in left colon. The prevalence of Solitary polyps, multiple polyps, familial adenomatous polyposis, and Peutz-Jeghers syndrome (PJS) was 10.3% (n=8), 6.4% (n=5), 3.8% (n=3), and 2.6% (n=2) respectively. Polyposis syndrome cases were more likely to have old age, diarrhea, anemia, and abdominal pain. Peutz-Jeghers syndrome majority patients experienced intestinal partial blockage with acute episodes, abdominal pain, and emergency laparotomy, resulting in increased morbidity. Conclusion: The present study found that clinical signs of polyposis syndrome include anemia, diarrhea, abdominal pain, polypectomy history, and older age at presentation. Despite the fact that the most commonly diagnosed kind of polyp was juvenile colonic polyps, the current investigation recognized a substantial number of polyposis syndromes children, which are related with individual’s higher rate of morbidity. Keywords: Colonic polyps, Clinical features, Endoscopic characteristics, Colonoscopy

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Juvenile Polyps in Bangladeshi Children and Their Association with Fecal Calprotectin as a Biomarker

Cited by 8 publications

References 30 publications

Fecal calprotectin measurement to detect recurrence of solitary juvenile polyps: A case report

Fecal calprotectin measurement to detect recurrence of solitary juvenile polyps: A case report

Associations of Polyp Characteristics in Children and Adolescents Presenting with Less Than Five Colorectal Polyps: A Full Colonoscopy Is Still Required

Clinical, Endoscopic and Pathological Characteristics of Colorectal Polyps in Children and Adolescents

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