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Early Symptoms in Children with Inflammatory Bowel Disease: Implications for Subsequent Bone Mineral Deficiency
Mariusz Olczyk1, Agnieszka Frankowska1, Marcin Tkaczyk1
1Department of Pediatrics, Immunology and Nephrology, Polish Mother's Memorial Hospital Research Institute, Medical University of Lodz, 90-419 Lodz, Poland.
Insights
Children with inflammatory bowel disease (IBD) often develop bone disorders like osteopenia and osteoporosis. Early detection and monitoring of IBD in children are crucial to prevent serious bone complications.
Area of Science:
- Pediatric Gastroenterology
- Pediatric Endocrinology
- Bone Metabolism
Background:
- Inflammatory bowel disease (IBD) encompasses Crohn's disease (CD) and ulcerative colitis (UC), conditions known to affect bone metabolism.
- Understanding the early clinical and diagnostic differences between CD and UC in children is vital for predicting bone health outcomes.
Purpose of the Study:
- To compare clinical and diagnostic parameters at diagnosis in pediatric CD and UC patients.
- To investigate the association between initial disease characteristics and the development of subsequent bone disorders.
Main Methods:
- Eighty children with newly diagnosed IBD underwent blood tests (calcium-phosphate metabolism) and fecal calprotectin tests.
- Bone densitometry was performed on 25 of these children.
Main Results:
- Diarrhea and bloody stools were more common in UC, while fever was more frequent in CD.
- Anemia and thrombocytosis were prevalent. Nearly half of the children had osteopenia, and 20% had osteoporosis.
- Low calcium levels and vitamin D insufficiency at diagnosis correlated with bone disorders.
Conclusions:
- Early identification of IBD in children is essential.
- Regular monitoring for bone health in pediatric IBD patients can mitigate risks such as osteoporosis.
Background:
Inflammatory bowel disease (IBD) is associated with multiple factors that influence bone metabolism. This study aimed to compare the clinical manifestations and diagnostic parameters of patients with Crohn's disease (CD) and ulcerative colitis (UC) at the time of diagnosis, as well as to assess their relationship with subsequent bone disorders.
Methods:
Blood tests (including calcium-phosphate metabolism) and fecal tests (including calprotectin) were performed in eighty children recently diagnosed with IBD. Additionally, the bone densitometry results were evaluated in 25 of them.
Results:
Diarrhea (p = 0.02) and bloody stools (p < 0.001) were more frequent in patients with UC, whereas fever was more common in patients with CD (p = 0.003). Laboratory tests revealed anemia in 62.5% (50/80) and thrombocytosis in 36.3% (29/80). Higher calprotectin levels in the feces were found in girls at the time of diagnosis (p = 0.02). Osteopenia was detected in almost half of the examined patients (12/25), and 20% (5/25) met the criteria for osteoporosis. Low calcium levels at diagnosis were correlated with subsequent bone disorders (p = 0.005). Insufficient levels of vitamin D were detected in 77.8% (56/80).
Conclusions:
Early disease detection and the appropriate monitoring of children with IBD may decrease the risk of serious consequences, including osteoporosis.
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