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Symptomatic colonic polyps in childhood: not so benign
E J Hoffenberg1, A Sauaia, T Maltzman
1Department of Pediatrics, University of Colorado School of Medicine, and The Children's Hospital, Denver, USA.
Journal of Pediatric Gastroenterology and Nutrition
|February 5, 1999
Summary
Juvenile polyposis coli (JPC) is common in children with symptomatic polyps, often presenting with anemia and right-colon polyps. Further research is needed on the familial risk of polyps and colorectal cancer in JPC cases.
Area of Science:
- Pediatric Gastroenterology
- Gastrointestinal Pathology
- Clinical Genetics
Background:
- The clinical spectrum of symptomatic polyps and the prevalence of familial polyposis in children are not well-defined.
- This study investigated a cohort of children with juvenile polyposis coli (JPC) and non-JPC polyps.
Purpose of the Study:
- To define the clinical characteristics and frequency of JPC in children presenting with symptomatic colonic polyps.
- To compare JPC cases with isolated juvenile polyps regarding polyp burden, associated findings, and molecular markers.
Main Methods:
- Retrospective review of endoscopic records for children with symptomatic colonic polyps and no family history.
- Defined JPC as ≥10 juvenile polyps or any juvenile polyp in a relative.
- Analyzed polyps for Ki-ras mutations, p53 overexpression, and aneuploidy.
Main Results:
- Seventy-eight children were identified; 12% had JPC, 84% had isolated juvenile polyps.
- JPC cases had significantly more polyps, a higher likelihood of anemia, adenomatous changes, and right-colon polyps.
- No Ki-ras mutations, p53 overexpression, or aneuploidy were detected in the polyps.
Conclusions:
- Juvenile polyposis coli is a significant diagnosis in children with symptomatic polyps, associated with anemia, adenomas, and right-sided polyps.
- The study highlights the need for further investigation into the risk of polyps and colorectal cancer in relatives of JPC patients.