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Background: Extraintestinal manifestations (EIM) are common in children and adults and their presence is associated with a higher severity of inflammatory bowel disease (IBD). In pediatrics, studies are scarce in Latin America and do not exist in Colombia. Objective: To describe the prevalence of EIM in children with IBD and the associated demographic, clinical, and biochemical characteristics. Methodology: Retrospective study of patients diagnosed with pediatric-onset IBD between 2007 and 2022 treated at an institution in Bogotá. A descriptive analysis was performed and in the groups with and without EIM clinical and biochemical variables were compared using Fisher's exact test, Student's T, and Mann-Whitney's U. Results: Of 71 confirmed cases, 45% had typical ulcerative colitis, 27% Crohn's disease, 7% atypical ulcerative colitis, 1.4% colonic Crohn's, and 20% unclassifiable IBD. Thirteen patients (18%) had at least one EIM, and mucocutaneous was the most frequent (58%). The time from symptoms onset to diagnosis was higher in the EIM group (13.2 years vs. 10.2 years; p = 0.02). Nocturnal diarrhea, hyporexia, and weight loss were more frequent in children with EIM. The EIM group showed lower hemoglobin levels, and higher globular sedimentation rate, and received biologics more frequently (38% vs. 23%, p = 0.2). Conclusions: The frequency of MEI in this series is similar to that reported in the literature; its presence is associated with higher disease severity, higher frequency of biological use, and longer time IBD diagnosis. [ABSTRACT FROM AUTHOR]

Introduction: This publication aims to show the clinical, endoscopic, and histological responses of two pediatric patients who received dupilumab as a management strategy for eosinophilic esophagitis. Dupilumab is a monoclonal antibody that inhibits the alpha chain of the interleukin (IL)-4 and IL-13 receptors involved in the Th2 inflammatory response. The potential therapeutic role of this biological drug has been demonstrated in pediatric clinical trials in other allergic pathologies, such as atopic dermatitis and asthma, with an adequate safety and effectiveness profile. Clinical cases: Two children with a personal history of atopy, allergic rhinitis, asthma, atopic dermatitis, and food allergy began with gastrointestinal symptoms that confirmed the diagnosis of eosinophilic esophagitis. Despite the different management strategies, adequate control of the disease was not achieved, and it is considered that they benefited from management with dupilumab due to the disease evolution and the coexistence of uncontrolled atopic dermatitis. Conclusions: In recent years, various management strategies in pediatrics have been published, particularly high-dose proton pump inhibitors, topical corticosteroids, and elimination diets. However, despite these strategies, at least one-third of patients may fail to achieve remission with initial treatment, making this entity a therapeutic challenge for the gastroenterologist and pediatric allergist. Our patients received the dose recommended for their weight and age and approved for asthma and atopic dermatitis, resulting in clinical and histological remission. The improvement in gastrointestinal symptoms was accompanied by better control of asthma, rhinitis, and dermatitis. None of the patients had adverse effects of the medication. [ABSTRACT FROM AUTHOR]