P083 Atypical disease phenotypes in paediatric ulcerative colitis: 5-year analyses of the EUROKIDS registry

Bie, Charlotte de; Levine, A.; Turner, Dan; Cucchiara, Salvatore; Sładek, M.; Murphy, Suzanne P.; Escher, Johanna C.

doi:10.1016/s1873-9946(12)60103-2

Cited by 22 publications

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“…De Bie és munkatár-sai az európai gyermek-IBD-regiszter (EUROKIDS) adatait dolgozták fel. Négyszáz huszonhét olyan gyermek -akiknél a diagnóziskor az alsó és a felső traktus minden szegmenséből történt biopszia -43%-ánál találtak granulomát [10]. Hazánkban Kovács és munkatársai 1984-2006 között diagnosztizált Crohn-beteg gyermekek adatait elemezve a granulomák gyakoriságát (sebészeti és endoszkópos minták együtt) 47%-nak találták [11].…”

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“…Négyszáz-huszonhét CD-s gyermek 43%-ánál találtak granulomát a diagnóziskor. A granulomás és a nem granulomás csoport között különbséget az életkor, nem, EIM, családi halmozódás, lokalizáció, viselkedés, fenotípus tekinteté-ben nem találtak [10].…”

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“…Ezekben az esetekben a diagnózis felállításában a granulomáknak döntő szerepe volt. Heresbach és munkatár-sai a betegek 8%-ában, de Bie és munkatársai a betegek 4%-ában találtak a felső gastrointestinalis rendszerben granulomát [4,10]. Hasonló jelentőségük van a terminalis ileumból származó mintákban a granulomáknak, ami betegeink 4,8%-ában segítette a diagnózis felállí-tását.…”

Section: Eredeti Közleményunclassified

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Frequency and characteristics of granulomas in 368 pediatric patients with Crohn’s disease

et al. 2013

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Bevezetés: A granulomák kulcsszerepet töltenek be a gyulladásos bélbetegségek diagnosztikájában. Nem tisztázott azonban jelentőségük a Crohn-betegség patogenezisében és klinikai megjelenésében. Célkitűzés: A szerzők célul tűzték ki a granulomák gyakoriságának és jelentőségének meghatározását a Magyar Gyermekkori Gyulladásos Bél-betegség Regiszter alapján. Módszer: 2007. január 1. és 2010. december 31. között 368 Crohn-beteg adatait elemezték. Eredmények: A granulomák gyakorisága a diagnóziskor 31,4% (111/353) volt. A granulomák izolált megjelenése a felső gastrointestinalis rendszerben 2,5%, a terminalis ileumban 5% volt. A granulomás és a nem granulomás csoport között nem volt eltérés a fenotípusban és aktivitási indexben. Az immunmoduláns és a biológiai kezelés gyakorisága hasonló volt a két csoportban. Következtetések: A granulomák gyakorisága hazánkban megegyezik a nemzetközi tapasztalatokkal. Kiemelendő, hogy a terminalis ileumban vagy a felső gastrointestinalis rendszerben izoláltan talált granulomák 13 Crohn-beteg gyermekből egynél járultak hozzá a diagnózis felállításához. Ezek az adatok felhívják a fi gyelmet arra, hogy a béltraktus minden szegmenséből vett többszörös biopsziás mintavétel a diagnózis felállításához nélkülözhetetlen. Orv. Hetil., 2013, 154, 1702-1708

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Frequency and characteristics of granulomas in 368 pediatric patients with Crohn’s disease

et al. 2013

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“…Crohn's disease (CD) is a chronic relapsing inflammatory disorder of the alimentary tract with a continuously increasing incidence in the pediatric population [1][2][3][4][5]. Compared to adults, childhood-onset CD typically shows a more active disease pattern and greater need for immunosuppressant therapy [4].…”

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“…Compared to adults, childhood-onset CD typically shows a more active disease pattern and greater need for immunosuppressant therapy [4]. Ileum is affected in 70% of children and is prone to stricture and fistula formation, which occur in about 25% of pediatric CD patients [3,4,6]. Resection of the affected bowel segment either because of such complications or for unresponsive luminal disease is performed in 30-50% of pediatric CD patients by young adulthood [4,7] and as many as 70% of operated patients require further surgery during their lifetime [8,9].…”

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Fecal calprotectin in the prediction of postoperative recurrence of Crohn's disease in children and adolescents

Hukkinen

Pakarinen

Merras‐Salmio

et al. 2016

Journal of Pediatric Surgery

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a b s t r a c t a r t i c l e i n f oBackground: Fecal calprotectin (FC) correlates with endoscopic recurrence of Crohn's disease (CD) in adults but has not been studied among children postoperatively. We aimed to analyze whether FC relates with postoperative CD recurrence in children. Methods: Altogether 51 postoperative endoscopies and FC measurements from 22 patients having undergone surgery for CD at age ≤18 years were included. Results: Ileocecal resection (n = 15), small bowel resection (n = 6), or left hemicolectomy (n = 1) was performed at median age of 15.1 (interquartile range 14.4-17.6) years. Following surgery, FC decreased significantly (659 vs. 103 μg/g, p = 0.001). During median follow-up of 5.7 (4.2-7.7) years, either endoscopic or histological recurrence occurred in 17 patients (77%). FC N139 μg/g at time of endoscopy or FC increase of 79 μg/g compared to first postoperative value was suggestive of endoscopic recurrence (Rutgeerts score i2-i4), while FC N101 μg/g or increase of 21 μg/g indicated histological recurrence. Best accuracy for prediction of recurrence was obtained by combining FC at endoscopy and the postoperative increase of FC. The corresponding AUROC values were 0.74 (95% 0.58-0.89) for endoscopic recurrence whereas 0.81 (95% CI 0.67-0.95) for histological recurrence. Conclusion: FC is a useful surrogate marker of postoperative recurrence also in pediatric CD patients.

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Pediatric inflammatory bowel disease: Is it really uncommon in Asian children?

et al. 2020

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Background/Aim: Inflammatory bowel disease (IBD) is said to be rare in Asian children, and there is scarce information from India. We therefore analyzed our experience of pediatric IBD. Methods: Prospectively maintained data of 105 consecutive children [median age 12 (IQR:7-14) years, 71 males] with IBD from July 2001 through June 2016 were retrospectively analyzed. Their detailed clinical features, endoscopic appearance, histopathology, and treatment outcomes were recorded. For Crohn's disease (CD), disease phenotype and disease location were assessed as per Paris classification. Results: Disease spectrum includes ulcerative colitis (UC), 55 (52%); CD, 43 (41%); and IBD-unclassified, 7 (7%). There was a significant increase in the number of cases in the last 5 years compared to the previous 10 years (63 vs. 42, r 2 = 0.96). Most UC cases (75%) had extensive/pancolitis, 74% of CD had colonic/ileocolonic disease, and 65% had inflammatory phenotype. Fever, growth failure, pain in abdomen, and need for surgery were significantly more frequent in CD than in UC (P < 0.0001). Over a median follow up of 19 (IQR: 7-48) months, remission was achieved in 48 of 51 (94%) UC patients and in 24 of 34 (70.6%) CD patients; an immunomodulator was required to maintain remission in 67% of UC cases. In CD, there was a significant reduction in the use of empirical antitubercular therapy (76%, P = 0.008) with time, and disease progressed in three. Conclusions: IBD is not uncommon, and the incidence seems to be increasing among Indian children. UC is more common than CD and is more often an extensive disease. CD is mainly an inflammatory phenotype. The majority of children with IBD required an immunomodulator to maintain remission.

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P083 Atypical disease phenotypes in paediatric ulcerative colitis: 5-year analyses of the EUROKIDS registry

Cited by 22 publications

References 0 publications

Frequency and characteristics of granulomas in 368 pediatric patients with Crohn’s disease

Frequency and characteristics of granulomas in 368 pediatric patients with Crohn’s disease

Fecal calprotectin in the prediction of postoperative recurrence of Crohn's disease in children and adolescents

Pediatric inflammatory bowel disease: Is it really uncommon in Asian children?

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