Pancreatic Associated Manifestations in Pediatric Inflammatory Bowel Diseases

Abstract

Inflammatory bowel diseases (IBDs) are chronic relapsing inflammatory conditions of the gastrointestinal tract, encompassing Crohn’s disease (CD), ulcerative colitis (UC) and inflammatory bowel disease unclassified (IBD-U). They are currently considered as systemic disorders determined by a set of genetic predispositions, individual susceptibility and environmental triggers, potentially able to involve other organs and systems than the gastrointestinal tract. A large number of patients experiences one or more extraintestinal manifestations (EIMs), whose sites affected are mostly represented by the joints, skin, bones, liver, eyes, and pancreas. Pancreatic abnormalities are not uncommon and are often underestimated, encompassing acute and chronic pancreatitis, autoimmune pancreatitis, exocrine pancreatic insufficiency and asymptomatic elevation of pancreatic enzymes. In most cases they are the result of environmental triggers. However, several genetic polymorphisms may play a role as precipitating factors or contributing to a more severe course. The aim of this paper is to provide an updated overview on the available evidence concerning the etiology, pathogenesis and clinical presentation of pancreatic diseases in IBD pediatric patients.

Special Issue: Autoimmune Disease Genetics

“…The authors suggested an accurate screening and monitoring of thyroid function and autoimmunity to improve clinical practice and healthcare in children and adolescents with genetic syndromes. In the narrative reviews, Ferrari and Stagi reported the current literature regarding the genetic, immune, and environmental factors as the possible underlying mechanism of autoimmunity in individuals with Down syndrome [ 7 ]; Ben-Skowronek presented an update on IPEX syndrome making the knowledge of the genetics fundamental to introducing novel treatment methods in that pathology [ 8 ]; Roszkowska et al presented actual knowledge relative to the pathogenesis of Sjogren’s Syndrome, considering the role of innate immunity, adaptive immunity, and genetics [ 9 ]; and finally, Cucinotta et al presented an updated overview on the available evidence concerning the etiology (with genetic pattern), pathogenesis, and clinical presentation of pancreatic involvement in pediatric inflammatory bowel diseases [ 10 ].…”