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Objectives: Syndromic diarrhoea/tricho-hepato-enteric syndrome (SD/THE) is a rare congenital syndrome. The main features are intractable diarrhoea of infancy, hair abnormalities, facial dysmorphism, intrauterine growth restriction and immune system abnormalities. It has been linked to abnormalities in two components of the putative human ski complex: SKIV2L and TTC37. The long-term outcome of this syndrome is still unknown. We aim to describe the long-term outcome, in the French cohort of patients born since 1992. Design: Review of the clinical and biological features of the 15 patients with SD/THE, followed in France and born between 1992 and 2010. Results: All patients presented typical SD/THE syndrome features, of intractable diarrhoea in infancy requiring parenteral nutrition, a facial dysmorphism with hair abnormalities, and immunological disorders. Half of them also had liver and skin abnormalities. Five children died, among which 3 died due to infections. Probabilities of survival according to the Kaplan-Meier method were 93.3%, 86.7%, 74.3 and 61.9%, respectively at 1 year, 5 years, 10 years and 15 years of age. 3/15 were weaned from parenteral nutrition (PN) with likelihood of weaning being 10% at 5 years and 40% at 10 years. At birth 80% were small for gestational age and the short stature persisted in 60%. Haemophagocytic syndrome was noted in 60% and mild mental retardation was present in 60%. Conclusions: SD/THE is a rare disease with high morbidity and mortality. Management should be focused on nutrition and immunological defects. [ABSTRACT FROM AUTHOR]

Background and study aims Currently available polyethylene glycol (PEG)-based preparations continue to represent a challenge in children. The aim of this study was to compare the efficacy and safety of a new low-volume PEG preparation with a conventional PEG-electrolyte solution (PEG-ES) in children and adolescents. Patients and methods This was a multicenter, randomized, observer-blind, parallel-group, phase 3 clinical trial, where patients were randomized between PMF104 (Clensia) and a conventional PEG-ES (Klean-Prep), and stratified by age stratum (2 to <6; 6 to < 12;12 to <18 years). The primary endpoint was to test the non-inferiority of PMF104 versus PEG-ES, in terms of colon cleansing. Safety, tolerability, acceptability, palatability, and compliance were also assessed. Efficacy endpoints were analyzed in the per protocol set (PPS) and full analysis set (FAS) and safety and tolerability endpoints in the safety set (SAF). Results Of the 356 patients enrolled, 258 were included in the PPS, 346 in the FAS, and 351 in the SAF. Non-inferiority of PMF104 was confirmed for children aged > 6 years and for all age groups in PPS and FAS, respectively. Optimal compliance was reported more frequently in the PMF104 than in the PEG-ES group, in both PPS (86.1% vs. 68.4%) and FAS (82.9% vs. 65.3%). Both preparations were equally safe and tolerable. Palatability and acceptability were considered better in the PMF104 group than in the PEG-ES group (27.1% vs. 15.3% and 15.3% vs. 3.5%, respectively). Conclusions In children aged 6 to 17 years, the new low-volume product PMF104 is non-inferior to the reference PEG-ES in terms of bowel cleansing, safety, and tolerability, with slightly better results in compliance, palatability, and acceptability., Competing Interests: Conflict of Interest AlfaSigma has funded this clinical trial with grants provided to the trial sites. Michela Padovani, Raffaella Tacchi and Fabio Cenci are Alfasigma employees. The remaining authors have no other conflict of interest to declare., (The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).)

Sodium dependent multivitamin transporter (SMVT) deficiency is a very rare autosomal recessive disorder characterized by multisystemic clinical manifestations due to combined biotin, panthotenic acid and lipoic acid deficiency. About 10 families have been described so far. Accurate diagnosis is crucial because of the possibility of a supplementation treatment with proven efficacy. Here we describe 4 new patients (3 additional families) originating from the same world region (Algeria, Maghreb). All patients, born form consanguineous parents, were homozygous carriers of the same intronic variation, outside of canonical sites, in the SLC5A6 gene encoding SMVT. RNA study in one family allowed confirming the pathogenic effect of the variation and re-classifying this variant of uncertain significance as pathogenic, opening the possibility of genetic counseling and treatment. The identification of the same variation in three distinct and apparently unrelated families is suggestive of a founder effect. The phenotype of all patients was very similar, with systematic optic atrophy (initially considered as a very rare sign), severe cyclic vomiting, and rapidly progressive mixed axonal and demyelinating sensory motor neuropathy., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Mansour-Hendili, Gitiaux, Harion, Latouche, Heron, Stojkovic, Rama, Smol, Sophie Jourdain, Mention, Nadjar, Schiff, Lemale, Ghoumid, Gottrand, Talbotec, Rötig, Funalot and Desguerre.)

Competing Interests: L’auteure déclare avoir participé à des interventions ponctuelles pour les entreprises Danone, Nesté, Biostime, Sodilac, Menarini, et avoir été prise en charge à l’occasion de déplacement pour congrès par Biocodex.

Peripheral neuroblastic tumors are the most common extracranial solid tumors in children. On the other hand, diarrheal neuroblastic tumors are quite rare and not easy to diagnose in the early stage. We report a case of neuroblastic tumor in a 2-year old girl presenting with aqueous diarrhea caused by paraneoplasic secretion of VIP., (Copyright © 2022 Elsevier Masson SAS. All rights reserved.)

Gluten intolerance in infants and children: what diagnosis and what recommendations? Gluten intolerance or celiac disease is a relatively common pathology that is still underdiagnosed in pediatrics due to its heterogeneous presentation. Apart from the classic form of malabsorption with diarrhea and growth retardation, pathology should be sought in the event of a family history of celiac disease, autoimmunity and in the context of certain syndromes. Other clinical or laboratory signs should also suggest the diagnosis. Any suspicion should lead to assays for total IgA and anti- transglutaminase IgA. If the child is symptomatic or not, the absence of upper gastrointestinal endoscopy with biopsies is possible to make the diagnosis after agreement of the family, if the levels of anti-transglutaminase IgA are greater than 10 times the upper limit of normal, and if the anti-endomysium IgA, assayed on a second sample, are also positive. Management is based on a strict gluten-free diet., Competing Interests: L’auteur déclare avoir participé à des interventions ponctuelles (travaux scientifiques, rapport d’expertise, activité de conseil, conférences, formations) et avoir été prise en charge à l’occasion de déplacements pour congrès par Biocodex, Danone, Nestlé, Biostime, Mead Johnson Nutrition, AbbVie, Adare Pharmaceuticals.

Competing Interests: L'auteur déclare avoir participé à des interventions ponctuelles et avoir été prise en charge à l'occasion de déplacements par : Biocodex, Danone, Nestlé, Biostime, Mead Johnson, Abbevie, ADARE.

INADEQUATE INFANT DIETS AND FALSE FOOD allergiesthe administration, by families, of more or less extensive avoidance diets of food to their infants has been a growing problem in recent years. Regardless of certain parental beliefs, these diets are also often set up to treat mild digestive disorders or suspected food allergies. In young children, these diets, without cow's milk protein, vegetarians or even vegans or eliminating foods on unsuitable allergological tests, not supervised by health professionals, can lead to nutritional complications which are sometimes serious and life-threatening. It is therefore important to detect possible nutritional deficiencies, to treat them and to resume, after explanations to the family, a diet as little restricted as possible., Competing Interests: J. Lemale déclare avoir participé à des interventions ponctuelles et avoir été prise en charge à l’occasion de déplacements par : Biocodex, Danone, Nestlé, Biostime, Mead Johnson, Abbevie, ADARE.A. Lemoine déclare percevoir une rémunération régulière indirecte de Soredab/Sodilac, avoir participé à des interventions ponctuelles pour NHS, Novalac, Nutricia, Sodilac, Modilac, Mead Johnson et avoir été prise en charge à l’occasion de déplacements par Sodilac.

Familial hypercholesterolemia in children and adolescents. Familial hypercholesterolemia is a common genetic disease. The dominant autosomal heterozygous form is most common in relation to the pathogenic mutation of a single gene responsible for a significant rise in LDL-cholesterol levels in childhood. In the absence of treatment, this abnormality exposes to a risk of early cardiovascular diseases in men and women. This pathology is totally asymptomatic in childhood. A lipid check-up should be proposed in case of a familial history of early cardiovascular diseases or severe dyslipidemia, if a mutation is already known in parents or if familial history is unknown. The diagnosis is suspected if LDL-cholesterol is > 1,6 g/L. A genetic assessment will be proposed according to family history and evolution. Management begins in childhood with the initial introduction of specific dietary measures. However, these are often insufficient requiring statin therapy from the age of 8., Competing Interests: J. Lemale déclare des liens ponctuels avec Nestlé (interventions) et avoir été prise en charge lors de congrès par Lactalis, Biocodex, Nutricia et Ménarini. P. Tounian déclare des liens ponctuels avec les entreprises Auchan, Blédina, Carrefour, Elior, Ercé, Mead-Johnson, Nestlé/ Guigoz, Novalac/ Ménarini et Pediact.

The syndromic diarrhea/trichohepatoenteric syndrome (SD/THE) is a rare and multi-system genetic disorder caused by mutation in SKIV2L or in TTC37 , two genes encoding subunits of the putative human SKI complex involved in RNA degradation. The main features are intractable diarrhea of infancy, hair abnormalities, facial dysmorphism, and intrauterine growth restriction. Immunologically this syndrome is associated with a hypogammaglobulinemia leading to an immunoglobulin supplementation. Our immune evaluation of a large French cohort of SD/THE patient revealed several immunological defects. First, switched memory B lymphocytes count is very low. Second, IFN-γ production by T and NK cells is impaired and associated with a reduced degranulation of NK cells. Third, T cell proliferation was abnormal in 3/6 TTC37 -mutated patients. These three patients present with severe EBV infection and a transient hemophagocytosis which may be related to these immunological defects. Moreover, an immunological screening of patients with clinical features of SD/THE could facilitate both diagnosis and therapeutic management of these patients.

Monolayered epithelia are composed of tight cell assemblies that ensure polarized exchanges. EpCAM, an unconventional epithelial-specific cell adhesion molecule, is assumed to modulate epithelial morphogenesis in animal models, but little is known regarding its cellular functions. Inspired by the characterization of cellular defects in a rare EpCAM-related human intestinal disease, we find that the absence of EpCAM in enterocytes results in an aberrant apical domain. In the course of this pathological state, apical translocation towards tricellular contacts (TCs) occurs with striking tight junction belt displacement. These unusual cell organization and intestinal tissue defects are driven by the loss of actomyosin network homoeostasis and contractile activity clustering at TCs, yet is reversed by myosin-II inhibitor treatment. This study reveals that adequate distribution of cortical tension is crucial for individual cell organization, but also for epithelial monolayer maintenance. Our data suggest that EpCAM modulation protects against epithelial dysplasia and stabilizes human tissue architecture.

Sex hormones have broader effects than regulating reproductive functions. Recent identification of membrane progestin receptors expressed in kidney prompted us to investigate their putative involvement in the renal effects of this hormone. We first focused our investigations on mPRalpha and gamma by analyzing three parameters 1/ their distribution along the mouse nephron and their subcellular location in native kidney, 2/ the ability of progesterone to stimulate ERK pathway and/or Ca(2+) release from internal stores in native kidney structures and 3/ the cellular localization of mPRalpha and its molecular determinants in heterologous expression system. We observed that 1/ mPRalpha expression is restricted to proximal tubules of both male and female mice whereas mPRgamma exhibits a much broader expression all along the nephron except the glomerulus, 2/ mPRalpha and gamma are not localized at the plasma membrane in native kidney, 3/ this expression does not permit either progesterone-induced ERK phosphorylation or Ca(2+) release and 4/ in HEK transfected cells, mPRalpha localizes in the endoplasmic reticulum (ER) due to a C-terminal ER retention motif (-KXX). Therefore, we have characterized mPRs in kidney but their role in renal physiology remains to be elucidated.