Inflammatory bowel disease in children and adolescents

Kelts, Drew; Grand, Richard J.

doi:10.1016/s0045-9380(80)80010-7

Cited by 28 publications

(17 citation statements)

References 94 publications

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“…Our study analyzed the distribution of acute inflammation in children with IBD. Like others (21,22), we found that 18% of children had involvement of the small bowel only, roughly 50% fewer than that reported in adults (2,11,13,(23)(24)(25). Similarly, more than half of the children with CD had abnormal accumulation of 99mT~-HMPAO-WBC in the ascending colon.…”

Section: Fig 2 Discontinuous Patterns Of Crohn's Colitissupporting

confidence: 80%

Distribution of acute bowel inflammation determined by technetium-labeled white blood cells in children with inflammatory bowel disease

1998

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Knowledge of the distribution of disease in patients with inflammatory bowel disease is important because it has diagnostic, prognostic, and therapeutic implications. We studied 215 patients with 99mTc-HMPAO-white blood cell scans, of whom 80 had Crohn's disease (CD), 34 had active ulcerative colitis (UC), and 31 were controls. In our 77 cases of active CD, uptake was seen exclusively in the small bowel in 18% of patients, only the large bowel in 44%, and both the large and small bowel in 38% of patients. Discontinuous colitis was seen in 63 of these patients. In the 29 cases of active UC, the uptake involved the entire colon in 50% of patients, extended farther than the sigmoid in 27% of patients, and was limited to the rectosigmoid in 23%. In the 29 cases of active UC, four of the scans incorrectly revealed discontinuous accumulation of 99mTc-HMPAO-WBC. In 31 controls, no significant colonic uptake was seen. Isolated small bowel involvement with CD is observed less frequently in children undergoing 99mTc-HMPAO-WBC scanning than in adults. In children, the segmental distribution of inflammation as depicted with 99mTc-HMPAO-WBC is similar to the radiologic distribution.

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Section: Fig 2 Discontinuous Patterns Of Crohn's Colitissupporting

confidence: 80%

Distribution of acute bowel inflammation determined by technetium-labeled white blood cells in children with inflammatory bowel disease

1998

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“…Il est crucial de recueillir des données sur le suivi à long terme de la maladie de Crohn précoce afin d'éviter l'extrapolation directe des données, des adultes aux enfants et aux adolescents. E arlier studies, mainly from pediatric centres in the United States and Europe (1)(2)(3)(4)(5)(6)(7)(8)(9), but also Canada (10,11), have described the clinical features and prognosis of Crohn's disease diagnosed in childhood or adolescence. Although patient numbers have been limited and durations of direct pediatric physician follow-up have been short, most features typical of adult-onset disease were seen.…”

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confidence: 99%

Long-Term Prognosis of Early-Onset Chrohn's Disease Diagnosed in Childhood or Adolescence

Freeman¹

2004

Canadian Journal of Gastroenterology

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Long-term follow-up data on Crohn's disease diagnosed before 20 years of age is limited. Mortality, intestinal malignancy and the need for resection were assessed in 224 patients with early-onset disease (96 males, 42.9%; 128 females, 57.1%). Mean follow-up was 12.2 years; more than 50% of patients were seen for over 10 years (almost 10% for over 25 years). Most patients were diagnosed from ages 13 to 19 years, rather than in childhood. Ileocolonic disease was most common (128 of 224; 57.1%), while upper tract involvement (42 of 224; 18.8%) was frequent. Complex disease with strictures (28.6%) or penetrating complications (46.4%) was common. To date, one patient with early-onset disease died from a drug overdose and one developed rectal cancer, but epithelial dysplasia has not been reported in endoscopic biopsies or resected intestine. One or more intestinal resections were required in 126 patients (56.3%; 58 males and 68 females). More than one resection was needed in 52 patients (23.2%). The mean time from diagnosis to first resection was 4.2 years and from first to second resection was 6.6 years, with most resections required in the first two years. Most patients who needed one or more resections had ileocolonic disease and had complex stricturing or penetrating disease. Information on long-term follow-up of early-onset Crohn's disease is crucial to avoid the direct extrapolation of adult data to children and adolescents.

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“…[2] Does rhGHtherapy for dwarfism due to malnutrition typically result in "catch-up growth" as in the present case? [3] Is GH-secretory dysfunction, determined in this case by provocative tests and analysis of nocturnal GHsecretion, specific to Crohn's disease, or does it also occur in patients with other diseases that interfere with balanced nutrition? Juvenile-onset Crohn's disease reportedly causes marked growth retardation or results in the delay of secondary sexual maturation (5, 6), whereas colitis ulcerosa, also a nonspecific inflammatory disease, rarely is accompanied by severe growth retardation.…”

Section: Discussionmentioning

confidence: 99%

“…Growth retardation or a delay in sexual maturation has occurred in children with certain chronic inflammatory bowel diseases (1)(2)(3). The pathogenesis of Crohn's disease (4) remains unclear.…”

Section: Introductionmentioning

confidence: 99%