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[Chronic inflammatory bowel diseases in childhood. Case contribution and critical considerations]
M Pellegrino1, M R D'Altilia, F Lotti
1Istituto di Ricovero e Cura a Carattere Scientifico, Ospedale Casa Sollievo della Sofferenza.
Insights
Pediatric inflammatory bowel disease (IBD), including Crohn's disease and ulcerative colitis, presents frequently in children, often with diagnostic delays. Early detection and management are crucial for addressing growth and psychological impacts.
Area of Science:
- Gastroenterology
- Pediatric Medicine
- Immunology
Context:
- Inflammatory bowel disease (IBD) encompasses Crohn's disease and ulcerative colitis, chronic gastrointestinal conditions.
- Pediatric IBD onset occurs between ages 4-18, presenting unique diagnostic and management challenges.
- Extraintestinal manifestations like arthritis and erythema nodosum are common in pediatric IBD.
Purpose:
- To analyze the clinical features, diagnostic delays, and treatment outcomes of chronic inflammatory bowel disease in pediatric patients.
- To evaluate the utility of 99mTc-HmPAO-labelled granulocytes scintigraphy as a non-invasive diagnostic tool in childhood IBD.
- To highlight the impact of pediatric IBD on patient growth and psychological well-being.
Summary:
- Retrospective analysis of 23 pediatric IBD patients revealed frequent occurrence and common diagnostic delays, particularly for Crohn's disease.
- Utilized clinical and histopathologic criteria, alongside non-invasive imaging like granulocyte scintigraphy for diagnosis and follow-up.
- Standard treatments included corticosteroids and sulfasalazine, with supportive measures, while acknowledging significant growth and psychological effects.
Impact:
- Highlights the need for increased awareness and timely diagnosis of IBD in children to mitigate long-term health consequences.
- Introduces 99mTc-HmPAO-labelled granulocytes as a valuable non-invasive tool for monitoring pediatric IBD.
- Emphasizes the comprehensive management required for pediatric IBD, addressing physical growth and psychological health.
Abstract:
The term "inflammatory bowel disease" describes 2 major categories of chronic disease: Crohn's disease and ulcerative colitis. Non specific chronic colitis and allergic colitis in childhood can usually be distinguished by clinical and histopathologic criteria. This study regards a retrospective analysis of 23 patients suffering from chronic inflammatory bowel disease. Clinical manifestations began between 4 and 18 years of age. The Authors report remarkable frequency in pediatric age and common diagnostic delay, especially in Crohn's disease. The possibility of extraintestinal symptoms (erythema nodosum, arthritis, iridocyclitis) is also showed. Moreover they analyse present diagnostic proceedings: in childhood the employ of 99 mTc-HmPAO-labelled granulocytes is a new and non invasive test useful in the follow-up of the patients. In the treatment corticosteroids and sulfasalazine are used in various combinations associated with general supportive measures. Finally the Authors confirm that chronic inflammatory bowel disease may cause, especially in childhood, remarkable involvement on the growth and several psychological disorders.