Early onset inflammatory bowel disease: manifestations, genetics and diagnosis

Moazzami, Bobak; Moazzami, Kasra; Rezaei, Nima

doi:10.24953/turkjped.2019.05.001

Cited by 15 publications

(15 citation statements)

References 92 publications

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“…Very early onset IBD (VEO-IBD) is defined as disease diagnosis under the age of 6 years, and it represents a unique subset of IBD patients [2]. Some of VEO-IBD patients present with immunodeficiency and have genetic causes of their disease which means that loss of function genetic mutations involving immune and/or cytokines pathways lead to development of intestinal inflammation [3].…”

Section: Introductionmentioning

confidence: 99%

Safety and Effectiveness of Vedolizumab for the Treatment of Pediatric Patients with Very Early Onset Inflammatory Bowel Diseases

Fabiszewska

Derda

Szymańska

et al. 2021

JCM

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Background: Vedolizumab (vedo) is effective for induction and maintenance of remission in adults with inflammatory bowel disease (IBD). Pediatric data are still limited, especially for the youngest children with very early onset disease (VEO-IBD). The aim of this study was to assess the safety and efficacy of vedo in VEO-IBD. Methods: We performed a retrospective review of pediatric IBD patients with VEO-IBD (defined as aged <6 years) receiving vedo. Data on demographics, disease behavior, activity, and previous treatments/surgeries were collected. Disease activity was assessed using the pediatric Crohn’s disease (CD) activity index (PCDAI) for CD or pediatric ulcerative colitis (UC) activity index (PUCAI) for UC. Primary outcome was clinical response after induction therapy with vedolizumab (4th dose week). It was defined as a decrease in PCDAI of at least 12.5 points between baseline and 4th dose week for CD, and a decrease in PUCAI of at least 20 points between baseline and this time for UC. Descriptive statistics were performed to analyze the data. Results: The study included 16 patients with VEO-IBD who have received vedo: 4/16 (25%) with CD, and 12/16 (75%) with UC at the median age of diagnosis 33.7 months (6.6 months–4.5 years). Median age at vedo initiation was 6.5 years (2.2–16.5 years). Among the analyzed individuals, 56.25% had failed more than one anti-tumor necrosis factor (TNF) alfa agent. Clinical response at 4th dose week was observed in 9/16 (56.3%) patients: mean baseline PCDAI score was 34.4 ± 1.9 and 10.6 ± 1.8 after induction therapy with vedo, while PUCAI score was 26 ± 6 vs. 18 ± 8, respectively. There was improvement in patients’ nutritional state: at baseline 2/16 (12.5%) children had body mass index (BMI) below 1 percentile and no child had such BMI after induction therapy with vedo. No infusion reactions or serious adverse events/infections were reported. Conclusion: Vedolizumab is safe and effective in the medical management of pediatric patients with VEO-IBD.

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Section: Introductionmentioning

confidence: 99%

Safety and Effectiveness of Vedolizumab for the Treatment of Pediatric Patients with Very Early Onset Inflammatory Bowel Diseases

Fabiszewska

Derda

Szymańska

et al. 2021

JCM

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“…The disease is characterized by chronic non-infectious inflammation of the gastrointestinal tract (GT) [ 1 ]. UC mainly affects the large intestine, whereas CD may involve the entire gastrointestinal tract [ 2 ]. UC is defined as an idiopathic, chronic, and recurrent inflammatory disease of the colon.…”

Section: Introductionmentioning

confidence: 99%

“…Currently, a relevant increase in the prevalence of IBD in children has been noted [ 5 ]. The group under 18 years of age represents an estimated 10–15% of diagnosed patients [ 2 ]. A particularly higher incidence rate has been observed in developed countries.…”

Section: Introductionmentioning

confidence: 99%

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Differences in Dietary Patterns of Adolescent Patients with IBD

et al. 2021

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Inflammatory bowel disease (IBD) includes Crohn’s disease (CD) and ulcerative colitis (UC). The prevalence of both in pediatric populations has been constantly increasing. This study aimed to analyze the diet of adolescent patients with IBD in comparison to healthy controls and the current dietary standards for the Polish population to further their optimal supplementation regimen. The study group consisted of 53 patients (21 girls and 32 boys) with IBD (CD: n = 27; UC: n = 26) at a mean age of 15.4 ± 2.4 and 14.7 ± 2.2, years for girls and boys, respectively. The control group (CG) consisted of 20 patients, and 72 h of recall diaries on nutrition were collected. The nutritional data were analyzed in the Dieta 6D dietary program. When compared to Polish dietary standards, the largest differences girls with IBD and boys with IBD were found for the intake of energy (61.9 and 71.9%), iodine (61.9 and 62.6%), folates (76.2 and 87.5%), vitamin D (100 and 96.9%), potassium (61.9 and 59.4%), and calcium (85.7 and 93.8%). The overconsumption of saturated fatty acids (SFA) (61.9 and 56.3%) and sodium (76.2 and 90.6%) in girls and boys, respectively, was noted. In relation to girls with CG, girls with IBD showed a significantly higher intake of energy (1751. 3 vs. 1558.6 p = 0.0224), total protein (71.3 vs. 56.2 p = 0.0217), animal protein (47.8 vs. 34.5 p = 0.0183), total carbohydrates (237.3 vs. 196.1 p = 0.0442), and assimilable carbohydrates (219.8 vs. 180.5 p = 0.7921). Boys in the CG consumed significantly more calcium (851.8 vs. 432 p = 0.0006), phosphorus (1024.3 vs. 1357.5 p = 0.0431), lactose (11.6 vs. 6.1 p = 0.0016), and riboflavin (1.7 vs. 1.3 p = 0.0123) compared to boys with IBD. Dietician care should therefore be mandatorily provided alongside outpatient care. Based on our results, we suggest that supplementation with the selected components be considered.

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“…The early diagnosis and treatment of Crohn's disease, acting as a complex and challenging clinical problem, is of great signifi cance for promoting remission, enhancing therapeutic effect, reducing complications, preventing recurrence and improving quality of life [1,2]. Early diagnosis depends on clinical manifestations, endoscopy, pathology, laboratory, and imaging [3,4]. Treatment in the early phase of the disease strives for mucosal healing to improve the prognosis of Crohn's disease [5][6][7].…”

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confidence: 99%