Pediatric Ulcerative Colitis from Prevalence to Outcome

Isa, Hasan M

doi:10.23937/2469-584x/1510046

Cited by 1 publication

(6 citation statements)

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“…This could be explained by the role of iron therapy given to patients with UC to treat IDA prior to the diagnosis. Patients with UC usually present with bloody diarrhea compared to those with CD who usually present with recurrent abdominal pain as shown in our previous studies [11,12]. This bloody diarrhea might mandate earlier presentation to healthcare services, earlier diagnosis of IDA, and prompt treatment with iron supplementation.…”

Section: Discussionmentioning

confidence: 65%

“…These findings can be justified as all 71 children with CD in their study presented with severe low bone mineral density (BMD) [ 1 ]. In our study, besides the high prevalence of vitamin D deficiency which can cause hypocalcemia, the second most common symptom in our patients was diarrhea [ 11 , 12 ]. Hypocalcemia can be a result of vitamin D deficiency, as well as small bowel inflammation [ 14 ].…”

Section: Discussionmentioning

confidence: 98%

“…Protein loss can occur in severe and active IBD [ 14 ]. Although oral intake of protein and protein-losing enteropathy were not assessed specifically in our study, both mechanisms might be relevant to our population, especially in patients with CD who presented more with anorexia, recurrent abdominal pain, and chronic diarrhea as shown in our previously published studies [ 11 , 12 ]. In this study, patients with CD were found to have more hypoproteinemia (16.1%) than patients with UC (12.8%), p=0.043.…”

Section: Discussionmentioning

confidence: 99%

“…In Bahrain, the estimated annual incidence of pediatric CD was 1/10 5 /year (ranging from 0 to 5 patients) with a prevalence of 9.32 patients per 100,000 [ 11 ]. For pediatric UC, the estimated annual incidence was 1/10 5 /year (ranging from 0 to 6 patients) while the prevalence was found to be 16.3 patients per 100,000 [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

“…In a recent study, the prevalence of anemia was 57%, iron (56%), ferritin (39%), vitamin A (25%), vitamin D (22%), copper (17%), zinc (10%), selenium (10%), vitamin E (5%), vitamin B12 (2%), and red blood cell folate (1%) [ 8 ]. IBD treatment agents may also affect the absorption of micronutrients [ 12 ]. Medications such as glucocorticoids inhibit the absorption of calcium, phosphorus, and zinc and may impair vitamins C and D metabolism [ 25 ].…”

Section: Introductionmentioning

confidence: 99%

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The Prevalence of Iron and Vitamin D Deficiencies in Pediatric Patients With Inflammatory Bowel Disease in Bahrain

Isa¹,

Alahmed²,

Mohamed³

et al. 2023

Cureus

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IntroductionInflammatory bowel diseases (IBD) are chronic diseases that can affect nutrient absorption leading to micronutrient deficiencies and biochemical abnormalities. This study aimed to assess certain serum micronutrients and nutritionally related biochemical markers levels in patients with pediatric IBD and to compare the actual levels and the prevalence of micronutrients deficiencies and biochemical abnormalities between patients with Crohn's disease (CD) and those with ulcerative colitis (UC). MethodsA retrospective cross-sectional study reviewing medical records of patients with IBD was conducted in the pediatric department, Salmaniya medical complex, Bahrain, from 1 January 1984 to 31 December 2021. Demographic data and laboratory results related to micronutrients and biochemical markers including full blood count, total protein, albumin, globulin, iron, ferritin, folic acid, vitamin B12, calcium, phosphorous, magnesium, and vitamin D levels were collected upon presentation before starting the treatment. Nutritional deficiencies were compared based on sex, nationality, type of IBD, age at presentation, disease duration, weight at diagnosis, and inflammatory markers levels including erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). ResultsOf 157 patients with pediatric IBD, 117 (74.5%) were included. Sixty-six (56.4%) patients were males. Sixtysix (56.4%) had CD and 51 (43.6%) had UC. No patient had indeterminant colitis. The mean age at presentation was 10.8±3.8 years. Most patients had one or more micronutrient deficiencies (n=110, 94%). Anemia was a common finding (n=79/116, 68.1%), with iron deficiency anemia (IDA) being predominant. Low iron levels were noted in 64/77 (83.1%) patients with a median of 5.0 (2.0-9.3) µmol/L (normal range, 11.6-31.3); isolated iron deficiency (ID) in 11/18 (61.1%) and IDA in 53/59 (89.8%) patients. Vitamin D deficiency was the second most common (n=45/61, 73.8%). Serum albumin, ferritin, calcium, phosphorous, and magnesium were deficient in 29.2%, 27.8%, 31.7%, 12.5%, and 10%, respectively. One patient had vitamin B12 deficiency while none had folate deficiency. Patients with CD had significantly lower serum iron (5.4±5.6 versus 8.1±6.09 µmol//L, p=0.02) and lower serum protein (71.7±8.7 versus 75.4±9.9 g/L, p=0.043) but higher serum ferritin (45 (19-110.2) versus 21.3 (10.3-51.2) µg/L, p=0.046) compared to those with UC. Elevated ESR was noted in 62/105 (59.1%) patients while high CRP was found in 67/104 (64.4%). Patients with low iron had higher ESR (28 (17-47) versus 14 (10-33) mm/h, p=0.028) and higher CRP (13.3 (1.6-42) versus 1.8 (0.9-4.6) mg/L, p=0.019) levels compared to those with normal levels. ConclusionPatients with pediatric IBD are at risk of multiple micronutrient deficiencies and biochemical abnormalities. Iron and vitamin D deficiencies are the most frequent. Patients with CD are more prone to have lower serum iron and protein levels than those with UC. ID was associated with elevated inflammatory markers.

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Section: Discussionmentioning

confidence: 65%