Venous Thrombotic Events in Hospitalized Children and Adolescents With Inflammatory Bowel Disease

Nylund, Cade M.; Goudie, Anthony; Garza, Jose M.; Crouch, Gary; Denson, Lee A.

doi:10.1097/mpg.0b013e3182801e43

Cited by 73 publications

(80 citation statements)

References 53 publications

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“…The sites of the TE were the cerebral vessels (54.3%), the vessels in the limbs (26.0%), the abdominal vessels (13.0%), and the vessels in the retina and lungs (6.7%). Nylund et al [29] reported that hospitalized children and adolescents with IBD are at increased risk for TE. Conservative methods such as hydration, mobilization, and pneumatic devices should be considered to prevent TE in hospitalized children with IBD.…”

Section: Discussionmentioning

confidence: 99%

Clinical Features and Extraintestinal Manifestations of Crohn Disease in Children

Lee¹,

Chun

Hwang

et al. 2016

Pediatr Gastroenterol Hepatol Nutr

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PurposeThe aim of this study was to investigate the clinical features and extraintestinal manifestations (EIMs) of Crohn disease (CD) in Korean pediatric patients.MethodsThe medical records of 73 children diagnosed with CD were retrospectively reviewed. Data regarding baseline demographic and clinical characteristics, including CD phenotype at diagnosis based on the Montreal classification, and clinical features and course of EIMs were investigated.ResultsFifty-two (71.2%) of the patients were males. The mean age of the patients was 12.5 years. The mean follow-up period was 3.4 years. The disease location was ileal in 3 (4.1%) of the patients, colonic in 13 (17.8%), ileocolonic in 56 (76.7%). The clinical behavior was inflammatory in 62 (84.9%) of the patients, stricturing in 8 (11.0%), and penetrating in 3 (4.1%). Perianal abscesses or fistulas were found in 37 (50.7%) of the patients. EIMs observed during the study period were anal skin tag in 25 patients (34.2%), hypertransaminasemia in 20 (27.4%), peripheral arthritis in 2 (2.7%), erythema nodosum in 2 (2.7%), vulvitis in 1 (1.4%), uveitis in 1 (1.4%), and pulmonary thromboembolism in 1 (1.4%).ConclusionPerianal diseases and manifestations were present in more than half of Korean pediatric CD patients at diagnosis. Inspection of the anus should be mandatory in Korean children with suspicious CD, as perianal fistulas, abscesses, and anal skin tags may be the first clue to the diagnosis of CD.

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Section: Discussionmentioning

confidence: 99%

Clinical Features and Extraintestinal Manifestations of Crohn Disease in Children

Lee¹,

Chun

Hwang

et al. 2016

Pediatr Gastroenterol Hepatol Nutr

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“…There appears to be an increased risk of deep venous thrombosis in adolescents and adults with IBD, and appropriate preventive measures, including mechanical pneumatic devices and/or chemical prophylaxis, should be deployed. 56,57 Symptomatic pediatric UC can be well treated surgically with acceptable morbidity and demonstrated excellent long-term outcomes. Contemporary operative management through minimally invasive techniques for all stages of operative care is used at many hospitals with children's surgical expertise.…”

Section: Operative Managementmentioning

confidence: 99%

Medical and Surgical Management of Pediatric Ulcerative Colitis

Cabrera

Sato

2018

Clinics in Colon and Rectal Surgery

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Inflammatory bowel disease (IBD) describes a spectrum of idiopathic, lifelong, and progressive intestinal inflammatory conditions that includes Crohn's disease, ulcerative colitis, and indeterminate colitis. A worldwide increase in the incidence of IBD has been observed. In comparison to adults, IBD occurring during childhood and adolescence has several unique clinical characteristics and surgical management issues. In this article, we provide an overview contrasting these important differences.

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“…7 In a retrospective cohort study analyzing data from 7 448 292 discharges across 5 nonconsecutive years, the relative risk of a TE in a hospitalized child or adolescent with IBD was 2.36. 8 The etiology of the increased risk of TE in IBD is unclear, although it may be due to increased inflammation leading to a combination of both a prothrombotic and a hypercoagulable state. The decision to initiate prophylaxis of venous thrombosis in children with IBD remains an area of debate.…”

Section: Question Are Patients With CD Predisposed To Coagulopathies?mentioning

confidence: 99%

“…The American College of Chest Physicians recommends pharmacologic prophylaxis, whereas the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition does not recommend prophylactic measures given the lack of evidence of efficacy. 8…”

Section: Question Are Patients With CD Predisposed To Coagulopathies?mentioning

confidence: 99%

Blood and Guts: A Case of Early Childhood Crohn’s Disease

Chang¹,

Sessions²,

Shillingford³

et al. 2016

Hospital Pediatrics

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A 3-year-old Latino boy was transferred to a tertiary children' s hospital after presenting with poor oral intake, several days of nonbloody/nonbilious emesis, and blood-streaked diarrhea. He was afebrile with normal vital signs; height was at the 15th percentile and weight at the sixth percentile; and BMI was 14.5 at the eighth percentile. He was a tired-appearing and pale toddler who was crying but consolable. He had dry lips with hyperactive bowel sounds but with a nontender and nondistended abdomen. He had bilateral pitting edema to his ankles and periorbital edema.He was previously diagnosed as an outpatient with iron-deficiency anemia. His bloody diarrhea was thought to be secondary to milk-protein enterocolitis due to both its onset being around the time his diet was diversified between 6 and 12 months of age and to the finding of hypoalbuminemia. He was on an elimination diet of milk products plus supplementation with an extensively hydrolyzed whey protein formula. He had an esophagogastroduodenoscopy and colonoscopy done 6 weeks before this hospitalization demonstrating friable, edematous, and nodular colonic mucosa, with no duodenal villi blunting or colonic cryptitis, granulomas, or dysplasia on biopsy. These results were inconclusive but suggested a degree of inflammation. a

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Venous Thrombotic Events in Hospitalized Children and Adolescents With Inflammatory Bowel Disease

Abstract: Hospitalized children and adolescents with IBD are at increased risk for TE. Conservative methods of TE prevention including hydration, mobilization, or pneumatic devices should be considered in hospitalized patients with IBD.

Cited by 73 publications

References 53 publications

Clinical Features and Extraintestinal Manifestations of Crohn Disease in Children

Clinical Features and Extraintestinal Manifestations of Crohn Disease in Children

Medical and Surgical Management of Pediatric Ulcerative Colitis

Blood and Guts: A Case of Early Childhood Crohn’s Disease

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