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Deterioro del crecimiento en niños japoneses con enfermedad inflamatoria intestinal: un estudio de cohorte
Hirotaka Shimizu1, Ryusuke Nambu2, Nao Tachibana3
1Center for Pediatric Inflammatory Bowel Disease, Division of Gastroenterology, National Center for Child Health and Development, Tokyo, Japan.
Journal of pediatric gastroenterology and nutrition
|August 28, 2025
Resumen
El deterioro del crecimiento (GI, por sus siglas en inglés) afecta a los niños con enfermedad inflamatoria intestinal (IBD, por sus siglas en inglés), particularmente a los pacientes jóvenes con colitis ulcerosa (UC, por sus siglas en inglés). El tratamiento temprano con esteroides y el monitoreo personalizado son clave para obtener mejores resultados en la EII pediátrica.
Área de la Ciencia:
- Gastroenterología pediátrica
- Investigación de las enfermedades inflamatorias intestinales
- Estudios de crecimiento y desarrollo
Sus antecedentes:
- El deterioro del crecimiento (GI) es una preocupación significativa en la enfermedad inflamatoria intestinal pediátrica (IBD).
- Comprender las características distintas y la prevalencia de la gastrointestinal en la colitis ulcerosa (UC) y la enfermedad de Crohn (CD) es crucial para un tratamiento eficaz.
- La identificación temprana y la intervención son vitales para optimizar los resultados de salud a largo plazo en los niños afectados.
Objetivo del estudio:
- Investigar la prevalencia y las características específicas del deterioro del crecimiento (GI) en niños diagnosticados con EII.
- Comparar los patrones de crecimiento y las tasas de recuperación entre los niños con UC y CD.
- Identificar factores de riesgo y subgrupos vulnerables dentro de la población pediátrica de EII.
Principales métodos:
- Un estudio observacional prospectivo en el que participaron 402 niños con UC (n=257) y CD (n=145) del Registro Pediátrico Japonés de EII (2012-2020).
- El deterioro del crecimiento (IG) se definió utilizando los criterios de clasificación de París.
- Los resultados longitudinales se evaluaron en 307 niños con al menos dos años de seguimiento.
Principales resultados:
- En el momento del diagnóstico, la prevalencia GI fue similar entre UC (6,2%) y CD (8,3%).
- Los niños con UC diagnosticados a los 0-4 años mostraron tasas GI significativamente más altas (35,3%).
- La recuperación del crecimiento a los 2 años fue menor en UC (9%) en comparación con CD (50%) entre los pacientes con IG inicial. La inflamación gastrointestinal de nueva aparición se produjo en el 23% de los casos de UC y en el 16% de los casos de CD, con inflamación gastrointestinal persistente en el 16% de los casos de UC y en el 11% de los casos de CD. El uso prolongado de corticosteroides se relacionó con la persistencia de la enfermedad gastrointestinal.
Conclusiones:
- Se observan patrones de crecimiento distintos en niños japoneses con EII, siendo los pacientes con UC más jóvenes particularmente vulnerables.
- Las lesiones del intestino delgado están asociadas con la enfermedad gastrointestinal, lo que pone de relieve la necesidad de una evaluación completa del intestino delgado.
- El monitoreo del crecimiento específico de la edad y centrado en el paciente y las estrategias tempranas de ahorro de esteroides son esenciales para mejorar los resultados a largo plazo en la EII pediátrica.
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