Extraintestinal Manifestations of Pediatric Inflammatory Bowel Disease: Prevalence, Presentation and anti-TNF Treatment

Autor: Thomas Greuter, Roman Rechner, Gerhard Rogler, Alex Straumann, Alain M. Schoepfer, Christian Braegger, Benjamin Misselwitz, Luc Biedermann, Laëtitia Marie Petit, Fabio Bertoldo, Andreas Nydegger, Raja Affendi Raja Ali, Johannes Spalinger, Klaas Heyland, Stephan R. Vavricka, Denise Herzog, Michael Scharl, Samuel Antonio Zamora, Raoul I. Furlano, Florian Froehlich, Jonas Zeitz, Michela G. Schäppi, Susanne Schibli, Pascal Mueller, Ekaterina Safroneeva
Přispěvatelé: University of Zurich, Vavricka, Stephan R, Swiss IBD Cohort Study Group
Jazyk: angličtina
Rok vydání: 2017
Předmět:
Male
Anti-Inflammatory Agents
Inflammatory bowel disease
Gastroenterology
Pediatrics
0302 clinical medicine
Crohn Disease
Prevalence
Child
610 Medicine & health
Stomatitis
education.field_of_study
ddc:618
Ulcerative colitis
Perinatology
and Child Health
10219 Clinic for Gastroenterology and Hepatology
Child
Preschool
030220 oncology & carcinogenesis
Cohort
Female
030211 gastroenterology & hepatology
Joint Diseases
360 Social problems & social services
Cohort study
medicine.medical_specialty
Adolescent
Cholangitis
Sclerosing
Population
Skin Diseases
Anti-Inflammatory Agents/therapeutic use
Cholangitis
Sclerosing/diagnosis
Cholangitis
Sclerosing/drug therapy
Cholangitis
Sclerosing/epidemiology
Cholangitis
Sclerosing/etiology
Colitis
Ulcerative/complications
Colitis
Ulcerative/diagnosis
Colitis
Ulcerative/drug therapy
Crohn Disease/complications
Crohn Disease/diagnosis
Crohn Disease/drug therapy
Follow-Up Studies
Humans
Infant
Infant
Newborn
Joint Diseases/diagnosis
Joint Diseases/drug therapy
Joint Diseases/epidemiology
Joint Diseases/etiology
Logistic Models
Retrospective Studies
Skin Diseases/diagnosis
Skin Diseases/drug therapy
Skin Diseases/epidemiology
Skin Diseases/etiology
Tumor Necrosis Factor-alpha/antagonists & inhibitors
Uveitis/diagnosis
Uveitis/drug therapy
Uveitis/epidemiology
Uveitis/etiology
Uveitis
03 medical and health sciences
Internal medicine
medicine
2715 Gastroenterology
2735 Pediatrics
Perinatology and Child Health
Colitis
education
Tumor Necrosis Factor-alpha
business.industry
Retrospective cohort study
medicine.disease
digestive system diseases
10036 Medical Clinic
Pediatrics
Perinatology and Child Health
Colitis
Ulcerative
business
Zdroj: Greuter, Thomas; Bertoldo, Fabio; Rechner, Roman; Straumann, Alex; Biedermann, Luc; Zeitz, Jonas; Misselwitz, Benjamin; Scharl, Michael; Rogler, Gerhard; Safroneeva, Ekaterina; Ali, Raja A; Braegger, Christian; Heyland, Klaas; Mueller, Pascal; Nydegger, Andreas; Petit, Laetitia-Marie; Schibli, Susanne; Furlano, Raoul I; Spalinger, Johannes; Schäppi, Michela; ... (2017). Extraintestinal Manifestations of Pediatric Inflammatory Bowel Disease: Prevalence, Presentation and anti-TNF Treatment. Journal of pediatric gastroenterology and nutrition, 65(2), pp. 200-206. Lippincott Williams & Wilkins 10.1097/MPG.0000000000001455
Journal of pediatric gastroenterology and nutrition, vol. 65, no. 2, pp. 200-206
Journal of Pediatric Gastroenterology and Nutrition, Vol. 65, No 2 (2017) pp. 200-206
ISSN: 0277-2116
Popis: There is a paucity of data on extraintestinal manifestations (EIM) and their treatment in pediatric patients with inflammatory bowel disease (IBD). Since 2008, the Pediatric Swiss IBD Cohort Study has collected data on the pediatric IBD population in Switzerland. Data on 329 patients were analyzed retrospectively. A total of 55 patients (16.7%) experienced 1-4 EIM (39 Crohn disease, 12 ulcerative colitis, and 4 IBD-unclassified patients). At IBD onset, presence of EIM was more frequent than in the adult population (8.5% vs 5.0%, P = 0.014). EIM were more frequent in Crohn disease when compared to ulcerative colitis/IBD-unclassified (22.5% vs 10.3%, P = 0.003). The most prevalent EIM were peripheral arthritis (26/329, 7.9%) and aphthous stomatitis (24/329, 7.3%). Approximately 27.6% of all EIM appeared before IBD diagnosis. Median time between IBD diagnosis and occurrence of first EIM was 1 month (-37.5-149.0). Thirty-one of the 55 patients (56.4%) were treated with 1 or more anti-tumor necrosis factor (TNF) agents. IBD patients with EIM were more likely to be treated with anti-TNF compared to those without (56.4% vs 35.0%, P = 0.003). Response rates to anti-TNF depended on underlying EIM and were best for peripheral arthritis (61.5%) and uveitis (66.7%). In a cohort of pediatric patients with IBD, EIM were frequently encountered. In up to 30%, EIM appeared before IBD diagnosis. Knowledge of these findings may translate into an increased awareness of underlying IBD, thereby decreasing diagnostic delay. Anti-TNF for the treatment of certain EIM is effective, although a substantial proportion of new EIM may present despite ongoing anti-TNF therapy.
Databáze: OpenAIRE
Externí odkaz: