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Drugs for Treatment of Ulcerative Colitis in IBD01:29

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Ulcerative colitis is a chronic inflammatory condition primarily affecting the colon and rectum. The primary drugs used in the treatment of ulcerative colitis are aminosalicylates. They exhibit anti-inflammatory and immunosuppressive properties. They modulate inflammatory mediators and inhibit the activity of nuclear factor κB (NF-κB). Aminosalicylates also reduce inflammation by inhibiting prostaglandin and leukotriene production and decreasing neutrophil chemotaxis and superoxide...
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Glucocorticoids, a class of anti-inflammatory drugs, are pivotal in treating moderate to severe Crohn's disease by inducing remission. They exhibit their anti-inflammatory action by inhibiting the production of inflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-1, and chemokines like IL-8. In addition, they reduce the expression of inflammatory cell adhesion molecules and inhibit gene transcription of nitric oxide synthase, phospholipase A2, cyclooxygenase-2...
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In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
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Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel...
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Drug distribution in the pediatric population exhibits unique challenges and considerations due to the physiological differences between children, particularly neonates and infants, and adults. A crucial aspect of pediatric pharmacology is understanding how these differences impact the pharmacokinetics of various drugs, necessitating age-specific dosing strategies to ensure efficacy and safety.Neonates and infants have a higher total body water content, ~75%–90% of their body weight,...
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In pediatric care, understanding the nuances of hepatic drug metabolism is crucial, as it significantly differs from that of adults. This divergence is primarily due to the developmental stage of drug-metabolizing enzymes, which affects how medications are processed in the body. In neonates, for instance, the activity of Phase I enzymes—critical for the initial breakdown of drugs—is markedly reduced, functioning at just 20–40% of the levels seen in adults. This reduction poses...
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CMV Infection in Pediatric IBD.

Anat Yerushalmy-Feler1,2, Sharona Kern-Isaacs2, Shlomi Cohen3,4

  • 1Pediatric Gastroenterology Unit, "Dana-Dwek" Children's Hospital, Tel Aviv Sourasky Medical Center, 6 Weizman Street, 6423906, Tel Aviv, Israel.

Current Gastroenterology Reports
|March 30, 2018
PubMed
Summary

Cytomegalovirus (CMV) colitis is rare in pediatric inflammatory bowel disease (IBD). In children with IBD, CMV colitis indicates more severe disease and resistance to steroids, similar to adults.

Keywords:
AdultsCMVChildrenCrohn’s diseaseIBDUlcerative colitis

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Area of Science:

  • Pediatric gastroenterology
  • Infectious diseases

Background:

  • Patients with inflammatory bowel disease (IBD) have an increased susceptibility to infections.
  • Cytomegalovirus (CMV) colitis is a known complication in adult IBD patients, particularly those with ulcerative colitis (UC), often indicating severe or steroid-refractory disease.

Purpose of the Study:

  • To review and summarize current data on the prevalence and clinical role of CMV colitis in pediatric IBD patients.

Main Methods:

  • Literature review of studies reporting on CMV colitis in children with IBD.
  • Analysis of prevalence, clinical presentation, and outcomes associated with CMV colitis in pediatric IBD.

Main Results:

  • Data on CMV colitis in children with IBD are limited due to its rarity.
  • Similar to adults, pediatric IBD patients with concurrent CMV colitis often exhibit more severe disease, steroid resistance, and a higher risk of colectomy.
  • The exact role of CMV—whether it exacerbates colitis or is merely a marker of severity—remains undetermined in both pediatric and adult populations.

Conclusions:

  • CMV colitis is an uncommon but significant complication in children with IBD.
  • Early recognition and management of CMV colitis are crucial for improving outcomes in pediatric IBD patients.
  • Further research is needed to elucidate the precise pathogenic role of CMV in pediatric IBD.