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1. Pediatric IBD-unclassified Is Less Common than Previously Reported; Results of an 8-Year Audit of the EUROKIDS Registry

Author

Dwight A., Winter, Karolewska-Bochenek, Katarzyna, Lazowska-Przeorek, Izabella, Lionetti, Paolo, Mearin, M. Luisa, Chong, Sonny K., Roma-Giannikou, Eleftheria, Maly, Jan, Kolho, Kaija-Leena, Shaoul, Ron, Staiano, Annamaria, Damen, Gerard M., de Meij, Tim, Hendriks, Danielle, George, Elvira K., Turner, Dan, Escher, Johanna C., The Paediatric IBD Porto group of ESPGHAN, Sładek, Małgorzata, Pediatric surgery, CCA - Innovative therapy, Pediatrics, Dwight A., Winter, Katarzyna Karolewska, Bochenek, Izabella Lazowska, Przeorek, Paolo, Lionetti, M., Luisa Mearin, Sonny K., Chong, Eleftheria Roma, Giannikou, Jan, Maly, Kaija Leena, Kolho, Ron, Shaoul, Staiano, Annamaria, Gerard M., Damen, Tim de, Meij, Daniëlle, Hendrik, Elvira K., George, Dan, Turner, Johanna C., Escher, Growth and Development, and Clinical sciences

Subjects
Male, Pancolitis, Pediatrics, medicine.medical_specialty, Adolescent, diagnosis, Audit, Disease, Endoscopy, Gastrointestinal, Interquartile range, Intestine, Small, IBD-unclassified, medicine, Immunology and Allergy, Humans, Eurokids registry, Registries, Diagnostic Errors, Israel, Child, Retrospective Studies, Medical Audit, Adolescent onset, medicine.diagnostic_test, business.industry, Gastroenterology, Retrospective cohort study, medicine.disease, Inflammatory Bowel Diseases, Ulcerative colitis, digestive system diseases, Endoscopy, childhood and adolescence, Europe, Radiography, Porto criteria, Female, medicine.symptom, business, Inflammatory diseases Radboud Institute for Molecular Life Sciences [Radboudumc 5]
Abstract

Background: Inflammatory bowel disease-unclassified (IBD-U) is diagnosed in ∼10% of pediatric and adolescent onset IBD patients. The EUROKIDS registry (2004) initiated by the Porto IBD working group of ESPGHAN prospectively monitors diagnostic workup of newly diagnosed pediatric and adolescent onset IBD patients. We aimed to describe diagnostic workup, phenotype, and change of diagnosis over time in pediatric IBD-U patients. Methods: Data were collected on children from 52 centers across 20 European countries and Israel, diagnosed with IBD from May 2005 through November 2013. Full endoscopy plus small bowel radiology was considered complete diagnostic workup. Participating centers reporting IBD-U patients were queried in 2014 for follow-up data. Results: IBD-U was the provisional first diagnosis in 265 of 3461 children (7.7%) (91/158 [58%] with pancolitis; 140 [53%] male), diagnosed more frequently under the age of 10 (median age 12.3 years, 89 [34%] under 10 years). Half (48%) had undergone complete diagnostic workup. Lack of small bowel radiology was the prevailing reason for incomplete workup. As a result of reinvestigations (endoscopy in 54%, radiology in 38%) during a median follow-up of 5.7 years (interquartile range, 2.5-7.8), a change in diagnosis from IBD-U to Crohn's disease (12%) or ulcerative colitis (20%) was reported. Conclusions: Only half of patients reported as IBD-U in EUROKIDS had undergone complete diagnostic workup. Follow-up with reinvestigations resulted in a reduction of IBD-U rate to 5.6%. A diagnosis of IBD-U becomes less likely in case of complete diagnostic workup. Implementation of clear diagnostic criteria will further reduce the rate of IBD-U in the future. © 2015 Crohn's & Colitis Foundation of America, Inc.

Published
2015
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2. WAO International Scientific Conference (WISC 2016) Abstracts

Author

Bao, Jun, Wang, Yi-Hui, Liu, Quan-Hua, Bao, Yi-Xiao, Azouz, Nurit, Caldwell, Julie, Ray, Leanne, Rochman, Mark, Mingler, Melissa, Eilerman, Matthew, Wen, Ting, Myers, Jocelyn Biagini, Hershey, Gurjit Khurana, Kottyan, Leah, Martin, Lisa, Marc, Rothenberg, Gonzalez-Uribe, Victor, Del Rio-Chivardi, Jaime, Del Rio-Navarro, Blanca, Lou, Hongfei, Ma, Siyuan, Zhao, Yan, Cao, Feifei, He, Fei, Liu, Zhongyan, Wang, Chengshuo, Bachert, Claus, Zhang, Luo, Abrams, Elissa, Becker, Allan, Kandhare, Amit, Bodhankar, Subhash, Grossman, Nicole, Doros, Gheorghe, Laden, Francine, Fuhlbrigge, Anne, Wechsler, Michael, Pace, Wilson, Yawn, Barbara, Israel, Elliot, Lee, Junehyuk, Adler, Frederick, Kim, Peter, Huang, Yung Feng, Chen, Ying Yao, Pan, Chiun Yen, Lee, Herng Sheng, Khalemsky, Michael, Schwartz, David G., Kolkhir, Pavel, Pogorelov, Dmitry, Kochergin, Nikolay, Komarow, Hirsh, Young, Michael, Eisch, Robin, Scott, Linda, Metcalfe, Dean, Singer, Alexander, Wakeman, Andrew, Gerstner, Thomas, Song, Woo-Jung, Shim, Ji-Su, Won, Ha-Kyeong, Kang, Sung-Yoon, Sohn, Kyoung-Hee, Kim, Byung-Keun, Jo, Eun-Jung, Kim, Min-Hye, Kim, Sang-Heon, Park, Heung-Woo, Kim, Sun-Sin, Chang, Yoon-Seok, Morice, Alyn H., Lee, Byung-Jae, Cho, Sang-Heon, Min, Kyung-Up, Boscolo, Maria Assunta, Brivio, Giulio, Bosisio, Sergio, Manzocchi, Nicoletta, Pulixi, Edoardo, Grignani, Giulia, D’Andrea, Eloisia, Ricci, Massimo, Passini, Elena, Italia, Maurizio, Urrutia-Pereira, Marilyn, Fagundes, Stefani, Oliano, Vinicius Jardim, Solé, Dirceu, Benzaquen, Sadia, Aragaki, Alejandro, Balestra, Ricardo, Harden, Dawn, Caudell-Stamper, Danielle, Glady, Gilbert, Holbreich, Mark, Lyakhovska, Nataliya, Kaidashev, Igor, Bystron, Jaromir, Hutyrova, Beata, Balakirski, Galina, Vanstreels, Luk, Wurpts, Gerda, Merk, Hans F., Baron, Jens Malte, Plange, Johanna, Rihs, Hans-Peter, Raulf, Monika, Roeseler, Stefani, Tolcachier, Alberto, Chamorro, Armando, Otero, Ruth, Brooks, Joel, Hess, Michael, Benz, Jared, MacDonald, Joseph, Chatha, Usma, Lent, Dale, Köse, Şükran, Tatar, Bengü Gireniz, Akkoçlu, Gülgün, Çukurova, İbrahim, Ödemiş, İlker, Toker, Ayşin Kılınç, Hasssan, Abdullahi, Gobir, Abdulrazaq Abdullahi, Kim, Cheol-Woo, Choi, Young Hwa, Lee, Jeong Hye, Cho, Rae Jeong, Nam, Yu Ran, Nam, Joo Hyun, Kim, Woo Kyung, Filipovic, Ivana, Zivkovic, Zorica, Filipovic, Djordje, Shik, Dana, Smith, Andrew, Hsi, Wang Yui, Friedman, Stuart, Gizaw, Yonatan, Bakhda, Rima, Mohammed, Kumail, Wasserman, Richard, Hague, Angela, Pence, Deanna, Rolen, Joanna, Sugerman, Robert, Silvers, Stacy, Kamili, Qurat, Knauer, Nadezhda, Zazernyi, Alexandr, Blinova, Elena, Demina, Daria, Kozlov, Vladimir, Agrawal, Komal, Kale, Sagar, Arora, Naveen, Vasilkova, Volha, Mokhort, Tatiana, Silvers, William, Eisenberg, Rachel, Mehta, Rushita, Rubinstein, Arye, Aston, Antony, Turner, Paul, Ruiz-Garcia, Monica, Boyle, Robert, Brown, Simon, Schejter, Yael Dinur, Ovadia, Adi, Kim, Vy, Reid, Brenda, Roifman, Chaim, Rosenfield, Lana, Avilla, Ernie, Harada, Laurie, Allen, Marilyn, Waserman, Susan, Yoon, Ho Joo, Koo, Gun Woo, Chang, Suk-Il, Yoon, Hye-Ran, Park, Dong Won, Park, Tai Sun, Moon, Ji-Yong, Kim, Tae Hyung, Sohn, Jang Won, Shin, Dong Ho, Jorjoliani, Tsici, Jorjoliani, Lia, Adamia, Nino, katamadze, Nona, Ramachandra, Deepika, Jorjoliani, Liana, Karseladze, Rusudan, Saginadze, Lali, Chkuaseli, Natalia, Dolgova, Anna, Stukolova, Olga, Sudina, Anna, Cherkashina, Anna, Shipulin, German, Rosenthal, Richard, Howe, Harvey, Knause, Paul, Greemberg, Rony, De Bruycker, Jean Jacques, Fernandez, Isabel, Le Deist, Françoise, Haddad, Elie, Rha, Yeong Ho, Lee, Kyung Suk, Choi, Sun Hee, Tam, Herman, Simons, Estelle, Simons, Elinor, Golebiowska-Wawrzyniak, Maria, Markiewicz, Katarzyna, Faitelson, Yoram, Stein, Miguel, Mandelberg, Avigdor, Dalal, Ilan, Levin, Michael, Hobane, Lelani, Basera, Wisdom, Botha, Maresa, Gray, Claudia, Zar, Heather, Kjaeva, Biserka Jovkovska, Arsovski, Zoran, Grivcheva-Panovska, Vesna, Odebode, Adeyinka, Adekunle, Adedotun, Adeonipekun, Peter, Farombi, Ebenezer, Camacho-Ordoñez, Nadezhda, Martinez-Vázquez, Alejandrina Josefina, García-Cruz, María de la Luz H., Tan, Qi, Min, Rui, Dai, Guan-qun, Xie, Wei-Ping, Mao, Huang, Wang, Hong, Yadav, Rakesh, Singh, Sneha, Yadav, Divya, Khaleva, Ekaterina, Bahnson, Henry T., Franz, Amber, Garvey, Lene Heise, Jay, Nicola, Haque, Rubaiyat, Fox, Adam, Lack, Gideon, du Toit, George, Radic, Snezana, Milenkovic, Branislava, Neskovic, Ana, Danojevic, Ljiljana, Nachshon, Liat, Goldberg, Michael, Levy, Michael, Katz, Yitzhak, Elizur, Arnon, Rosario, Cristine, Kasper, Juliana, Chong-Neto, Herbeto, Riedi, Carlos, Rosario, Nelson, Levy, Michael B., Har-Even, Ronly, Carmel, Mor, Goldberg, Michael R., Kherkheulidze, Maia, Kavlashvili, Nani, Kandelaki, Eka, Adamai, Nino, Ubiria, Irma, Burke, Andrea, Kastner, Monika, Zheleva, Denica, Darlenski, Razvigor, Bozinakis, Konstantinos, Kriebardis, Anastasios, Styliara, Sofia, Karastathi, Aikaterini, Farmakas, Nikolaos, Ribeiro, Maria Luiza Kraft Kohler, Barcellos, Ana Carolina, Silva, Hannah Gabriele Ferreira, Carletto, Luís Henrique Mattei, Bet, Marcela Carolina, Rossetto, Nathalia Zorze, Rosario, Nelson Augusto, Chong-Neto, Herberto Jose, Valença, Fernanda, Novaes, Marina, Gomes, Mariana, Seifert, Carla, Neto, Alfredo, Loyola, Flavia, Rios, José, Silva, Tatiana, Neves, Aline, Abadoglu, Oznur, Gemicioglu, Bilun, Bayram, Hasan, Cimrin, Arif, Akyildiz, Levent, Cilli, Aykut, Gunen, Hakan, Ozlu, Tevfik, Suerdem, Mecit, Uzaslan, Esra, Misirligil, Zeynep, Ristic-Stojanovic, Snezana, Milicevic, A., Milenkovic, A., Cvejic, Jelena, Jankovic, Jelena, Dimic-Janjic, Sanja, Djurdjevic, Natasa, Barzylovych, Vladyslava, Umanets, Tetiana, Barzylovych, Anastasia, Winkler, Karyn, Margarinos, Jessica, Martin, Dylan, Nowakowski, Maja, Joks, Rauno, Zangen, Tsili, Bernadsky, Olga, Boaz, Mona, Hermann, Gratiana, Aviv, Rachel, Kuperboim, Olga, Ramichanov, Larisa, Broide, Efrat, Shamir, Raanan, Zevit, Noam, Shaoul, Ron, Fich, Alex, Levine, Arie, Melamed, Isaac, Gangwar, Roopesh Singh, Minai-Fleminger, Yael, Seaf, Mansour, Gutgold, Amichai, Shikotra, Aarti, Chauhan, Anoop, Holgate, Stephen, Bradding, Peter, Howarth, Peter, Eliashar, Ron, Berkman, Neville, Levi-Schaffer, Francesca, Woo, Sung-il, Celik, Betul, Bulut, Tangul, Yalcin, Arzu Didem, Caldas, Luiz Querino, Confino-Cohen, Ronit, Rosman, Yossi, Goldberg, Arnon, Breuer, Oded, Singh, Roopesh, Barhoum, Ahlam, Kerem, Eitan, Slavyanskaya, Tatiana, Sepiashvili, Revaz, Blinova, Elena A., Pashkina, Ekaterina A., Leonova, Marina I., Nepomnyaschikh, Vera M., Demina, Darya V., Kozlov, Vladimir A., Shamri, Revital, Young, Kristen M., Weller, Peter F., de Paula Vieira, Rodolfo, Oliveira-Junior, Manoel Carneiro, Damasceno-Rodrigues, Nilsa Regina, Arantes-Costa, Fernanda Magalhães, Martins, Milton Arruda, Oliveira, Ana Paula Ligeiro, Bernard, Alfred, Sardella, Antonia, Voisin, Catherine, Royce, Simon, Philpott, Hamish, Nandurkar, Sanjay, Thien, Francis, Gibson, Peter, Bianchini, Rodolfo, Roth-Walter, Franziska, Ohradanova-Repic, Anna, Hofstetter, Gerlinde, Herrmann, Ina, Carvalho, Maria Isabel, Hufnagl, Karin, Bajna, Erika, Roth, Georg, Stockinger, Hannes, Jensen-Jarolim, Erika, Almog, Meital, Kessel, Aharon, Apov, Larisa, Salguero, Carlos Sanchez, Chacon, Alvaro Sanchez, Nazarov, Abbos, Ergashev, Shaxbos, Nesterova, Irina, Kovaleva, Svetlana, Chudilova, Galina, Lomtatidze, Ludmila, De Schryver, Sarah, Dery, Alizee, Clarke, Ann, Nadeau, Kari, Weatherall, Kimberly, Greenwood, Celia, Daley, Denise, Asai, Yuka, Ben-Shoshan, Moshe, Balmasova, Irina, Malova, Elena, Wagner, Stefanie, Pacios, Luis F., Wallner, Michael, Wiederstein, Markus, Tevs, Anna E., Tataurshchikova, Nataly, Sangidorj, Baigalmaa, Ronzhina, Anna, Chikhladze, Manana, Wirz, Oliver F., van de Veen, Willem, Mirer, David, Morita, Hideaki, Altunbulakli, Can, Johnston, Sebastian L., Glanville, Nicholas, Papadopoulos, Nikolaos G., Akdis, Cezmi A., Akdis, Mübeccel, Reshef, Avner, Riedl, Marc, Panovska, Vesna Grivcheva, Moldovan, Dumitru, Baker, James, Yang, William H., Andrejevic, Sladjana, Lockey, Richard F., Hakl, Roman, Kivity, Shmuel, Bellizzi, Luca, Harper, Joseph R., Relan, Anurag, and Cicardi, Marco

Subjects
lcsh:Immunologic diseases. Allergy, Pulmonary and Respiratory Medicine, 010504 meteorology & atmospheric sciences, business.industry, Immunology, Library science, Meeting Abstracts, 01 natural sciences, 03 medical and health sciences, 0302 clinical medicine, 030228 respiratory system, Immunology and Allergy, Medicine, lcsh:RC581-607, business, 0105 earth and related environmental sciences, Wechsler Intelligence Scale for Children
Published
2017
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3. Differences in Outcomes Over Time With Exclusive Enteral Nutrition Compared With Steroids in Children With Mild to Moderate Crohn’s Disease: Results From theGROWTH CDStudy

Author

Ron Shaoul, Malgorata Sladek, Sibylle Koletzko, Jorge Amil Dias, Javier Martín de Carpi, Annamaria Staiano, Rotem Sigall Boneh, Gábor Veres, Federica Nuti, Arie Levine, N. Cohen-Dolev, Seamus Hussey, Sivan Ben Avraham Shulman, Dan Turner, Tomer Ziv-Baran, Richard K. Russell, Anders Paerregaard, Tamar Pfeffer Gik, Paolo Lionetti, Chen Sarbagili Shabat, Cohen-Dolev, Noa, Sladek, Malgorata, Hussey, Seamu, Turner, Dan, Veres, Gabor, Koletzko, Sibylle, Martin de Carpi, Javier, Staiano, Annamaria, Shaoul, Ron, Lionetti, Paolo, Amil Dias, Jorge, Paerregaard, Ander, Nuti, Federica, Pfeffer Gik, Tamar, Ziv-Baran, Tomer, Ben Avraham Shulman, Sivan, Sarbagili Shabat, Chen, Sigall Boneh, Rotem, Russell, Richard K, and Levine, Arie

Subjects
Male, medicine.medical_specialty, Pediatrics, Adolescent, Constriction, Pathologic, Severity of Illness Index, Gastroenterology, Inflammatory bowel disease, 03 medical and health sciences, Enteral Nutrition, 0302 clinical medicine, Crohn Disease, Adrenal Cortex Hormones, Recurrence, Internal medicine, Severity of illness, medicine, Humans, Rectal Fistula, Prospective Studies, 030212 general & internal medicine, Child, Propensity Score, Prospective cohort study, Biological Products, Crohn's disease, business.industry, Remission Induction, Mean age, General Medicine, medicine.disease, Abscess, Body Height, Treatment Outcome, Parenteral nutrition, Propensity score matching, Female, 030211 gastroenterology & hepatology, business, Complication
Abstract

Background: Exclusive enteral nutrition [EEN] and corticosteroids [CS] induce similar rates of remission in mild to moderate paediatric Crohn's disease [CD], but differ with regard to mucosal healing. Our goal was to evaluate if EEN at diagnosis was superior to CS for improving long-term outcomes. Methods: We prospectively followed newly diagnosed children aged < 17 years, with mild to moderate CD at baseline, for 2 years in the GROWTH CD study. Patients were evaluated at baseline and at 8, 12, 78, and 104 weeks. Remission, relapses, complications [fibrostenotic disease, penetrating disease, and active perianal disease] and growth were recorded throughout the study. A propensity score analysis was performed. Results: A total of 147 children [mean age 12.9 +/- 3.2 years], treated by EEN [n = 60] or CS [n = 87] were included. New complications developed in 13.7% of CS [12/87] versus 11.6% of EEN [7/60], p = 0.29. Remission was achieved in 41/87 [47%] in CS and 38/60 [63%] EEN, p = 0.036. Median time to relapse did not differ [14.4 +/- 1 months with CS, 16.05 +/- 1.1 EEN, p = 0.28]. Mean height Z scores decreased from Week 0 to Week 78 with CS [-0.34 +/- 1.1 to -0.51 +/- 1.2, p = 0.01], but not with EEN [-0.32 +/- 1.1 to -0.22 +/- 0.9, p = 0.56]. In a propensity score analysis, EEN was superior to CS for inducing remission [p = 0.05] and trended to superiority for height Z score [p = 0.055]. Conclusions: Use of EEN was associated with higher remission rates and a trend toward better growth but with similar relapse and complication rates in new-onset mild to moderate paediatric CD.

Published
2017
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4. Surgical Management of Crohn Disease in Children: Guidelines From the Paediatric IBD Porto Group of ESPGHAN

Author

Mikko P. Pakarinen, Frank M. Ruemmele, Javier Martín-de-Carpi, Christine Spray, Iva Hojsak, Ian D. Sugarman, Sanja Kolaček, Dan Turner, Annamaria Staiano, Sibylle Koletzko, Ron Shaoul, Sonny K. F. Chong, Paolo Lionetti, Devinder Kumar, John Fell, Harland S. Winter, Anders Paerregaard, Risto Rintala, David C. Wilson, Jean-Pierre Hugot, Nadeem A. Afzal, Craig W. Lillehei, Kaija-Leena Kolho, Izabella Lazowska-Przeorek, Katarzyna Karolewska-Bochenek, Jiri Bronsky, Jorge Amil-Dias, Amil Dias, Jorge, Kolacek, Sanja, Turner, Dan, Pærregaard, Ander, Rintala, Risto, Afzal, Nadeem Ahmad, Karolewska Bochenek, Katarzyna, Bronsky, Jiri, Chong, Sonny, Fell, John, Hojsak, Iva, Hugot, Jean Pierre, Koletzko, Sibylle, Kumar, Devinder, Lazowska Przeorek, Izabella, Lillehei, Craig, Lionetti, Paolo, Martin de Carpi, Javier, Pakarinen, Mikko, Ruemmele, Frank M, Shaoul, Ron, Spray, Christine, Staiano, Annamaria, Sugarman, Ian, Wilson, David C, Winter, Harland, and Kolho, Kaija Leena

Subjects
medicine.medical_specialty, Placebo-controlled study, MEDLINE, Anti-Inflammatory Agents, Inflammatory bowel disease, Perioperative Care, law.invention, 03 medical and health sciences, 0302 clinical medicine, Postoperative Complications, Randomized controlled trial, Crohn Disease, law, Recurrence, Intestine, Small, Secondary Prevention, Medicine, Humans, Elective surgery, Intensive care medicine, Child, Colectomy, business.industry, Incidence (epidemiology), Patient Selection, Anastomosis, Surgical, Gastroenterology, Perioperative, medicine.disease, Surgery, Biological Therapy, Chemotherapy, Adjuvant, Elective Surgical Procedures, 030220 oncology & carcinogenesis, Pediatrics, Perinatology and Child Health, 030211 gastroenterology & hepatology, business, Elective Surgical Procedure, Immunosuppressive Agents
Abstract

The incidence of Crohn disease (CD) has been increasing and surgery needs to be contemplated in a substantial number of cases. The relevant advent of biological treatment has changed but not eliminated the need for surgery in many patients. Despite previous publications on the indications for surgery in CD, there was a need for a comprehensive review of existing evidence on the role of elective surgery and options in pediatric patients affected with CD. We present an expert opinion and critical review of the literature to provide evidence-based guidance to manage these patients. Indications, surgical options, risk factors, and medications in pre- and perioperative period are reviewed in the light of available evidence. Risks and benefits of surgical options are addressed. An algorithm is proposed for the management of postsurgery monitoring, timing for follow-up endoscopy, and treatment options.

Published
2017

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