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Microscopic colitis in children: A single-center experience and systematic review
Laura M Hernández Díaz1, Bashar Hasan2, Alaa Almallouhi3
1Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, USA.
Budesonide is effective for pediatric microscopic colitis (MC), often used alone or combined. However, high recurrence rates persist after treatment cessation in children with this inflammatory bowel disease.
Area of Science:
- Pediatric Gastroenterology
- Inflammatory Bowel Disease
- Histopathology
Background:
- Microscopic colitis (MC) is a significant cause of chronic diarrhea in adults, yet its occurrence and characteristics in children are less understood.
- Limited data exist regarding the presentation, treatment efficacy, and long-term outcomes of pediatric MC.
Purpose of the Study:
- To analyze a single-center's experience with pediatric microscopic colitis.
- To conduct a systematic literature review to consolidate existing knowledge on pediatric MC.
Main Methods:
- Retrospective analysis of electronic health records for pediatric patients diagnosed with MC.
- Systematic review of published literature on pediatric microscopic colitis cases.
Main Results:
- Budesonide, used as monotherapy or in combination, demonstrated the highest effectiveness in the single-center cohort.
- Across the literature, budesonide and 5-aminosalicylates were common treatments, with combination therapies (budesonide + biologic/mesalamine) showing superior efficacy.
- While corticosteroids yielded the highest remission rates, budesonide monotherapy was also effective. Recurrence rates were high (69%) overall, with biologics and bismuth showing the lowest recurrence.
Conclusions:
- Budesonide, alone or in combination, is a primary and effective treatment for pediatric MC.
- High recurrence rates following treatment discontinuation highlight the need for ongoing management strategies.
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