Gastrointestinal complications of epidermolysis bullosa in children

E B Freeman1, J Köglmeier, A E Martinez

  • 1Department of Paediatric Gastroenterology, Great Ormond Street Hospital for Children NHS Trust, Great Ormond Street, London WC1N 3JH, UK.

Insights

Gastrointestinal complications are common in inherited epidermolysis bullosa (EB), affecting 58% of children. Specific GI issues like constipation, reflux, and enteropathy vary by EB subtype, impacting patient care.

Area of Science:

  • Pediatric Gastroenterology
  • Dermatology
  • Genetics

Background:

  • Epidermolysis bullosa (EB) encompasses inherited disorders causing skin and mucous membrane fragility.
  • Gastrointestinal (GI) complications are frequent in EB, contributing significantly to patient morbidity.

Purpose of the Study:

  • To determine the frequency and nature of GI complications in a large pediatric EB cohort.
  • To explore subtype-specific patterns of GI involvement in EB.

Main Methods:

  • Retrospective review of medical records for 223 pediatric EB patients.
  • Analysis of documented GI symptoms, diagnostic investigations, and treatments.

Main Results:

  • 58% of patients experienced GI complications.
  • EB simplex: constipation and gastro-oesophageal reflux (GOR).
  • Junctional EB: failure to thrive and protein-losing enteropathy (PLE).
  • Dystrophic EB (DEB): constipation, GOR, esophageal strictures (recessive DEB), gastrostomy needs (recessive DEB), and diarrhea/colitis (recessive DEB).

Conclusions:

  • GI problems are highly prevalent in EB, with distinct patterns across subtypes.
  • Diarrhea, PLE, and colitis in EB may result from gut mucosal fragility and antigenic exposure.
Abstract

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