Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Inflammatory Bowel Disease (Ibd):Very Young Patients Can Also Be Affected

15.07.2008
Inflammatory Bowel Disease or IBD – a condition that includes both Crohn’s Disease and Ulcerative Colitis – is no longer limited to the adult population.

A research carried out by the Pediatric Clinic of the University of Trieste (Italy) at the Institute for Maternal and Child Health Burlo Garofolo, a hospital highly specialized in infant health, reports an increased prevalence of IBD not only among the general pediatric population, but surprisingly, also in children younger than two years of age.

The study, launched in 1984 and completed along 20 years, was recently published by the European Journal of Pediatrics. It reached two main conclusions:

-very early onset IBDs (before the age of 2) represent an estimated 9% of all the pediatric onset IBDs (occurring before the age of 16)

-these early forms are particularly severe versions of the disease and may hide an underlying inborn error of the immune system, therefore they require a more invasive therapy other than surgical and immunosuppressive therapies.

Moreover, since the disorder may initially be mistaken as a food allergy, the diagnosis is often delayed.

The Pediatric Clinic of the IRCCS Burlo Garofolo followed 184 patients affected by IBD for a minimum of two years. 8.6% of these (16 children) were diagnosed with IBD within their second year of life (as many as 12 children were diagnosed before the first year). In 12 out of 16 cases the IBD diagnosis was confirmed by additional investigations, while in the remaining 4 cases other conditions involving the immune system were identified.

As many as half of the patients were initially classified as allergic to cow’s milk proteins. For this reason they underwent an exclusion diet for a long time, despite the absence of any clinical benefit. Overall, these cases turned out being more severe if compared to the ones with a later onset and often surgical and aggressive immunosuppressive treatment were required.

“Being in the privileged position of reference centre that followed more than 300 IBD pediatric cases in the last two decades – underlines Alessandro Ventura, director of the Pediatric Clinic of the University of Trieste at the IMCHBG – we realized that IBD can have a very precocious onset: if this is the case, the disease tends to be particularly severe. In the past, IBD was long considered specific of the adult population, therefore pediatricians rarely looked for it within the pediatric groups.

Even today IBD symptoms are often misclassified as cow’s milk protein allergy, which causes a severe diagnostic delay. For this reason, the presence of an inflammatory intestinal disorder should be kept in mind by the pediatricians: if an intestinal problem, such as bloody-mucous diarrhoea, persists after 3-4 weeks, especially if in the presence of fever, impaired growth, weight loss, perianal fistulas or abscesses, one should include IBD in the differential diagnosis.”

“We estimate that in our region, Friuli Venezia Giulia, some 50 children suffer from the disease” explains Stefano Martelossi, Director of the Department of Gastroenterology at IMCHBG. “At present, our center is following 50 patients from FVG affected by this disorder and more than 200 from other Italian regions. This study proved that IBDs can show up at any age, including the very first years of life. Therefore, it is mandatory that pediatricians be well aware and alerted to promptly recognize the disease. The earlier the onset the more severe the disease, and the more negative the consequences of a diagnostic delay. One should also keep in mind that, in some cases, a very precocious onset might hide and underlying inborn error of immunity.”

MORE INFORMATION ON IBD
IBD is a family of chronic invalidating disorders characterized by inflammation of the intestinal mucosa, diarrhoea, maladsorption, blood in the stools and other complications. While the genetic predisposition to the disorder has been demonstrated, several hypotheses based on an alteration of intestinal immunity have been proposed to explain the recent increase in the disease prevalence among both adult and pediatric population.

Currently, no definite therapy exists for IBD. However, recently, several so-called biological drugs made by monoclonal antibodies, tailor-made to inactivate specific targets such as the molecules that trigger inflammation, were used to treat IBD. A prompt use of these medications allows a better control of the symptoms and offers the patients an acceptable quality of life.

Reference:

"IBD and IBD mimicking enterocolitis in children younger than 2 years of age"

Z. Cannioto1, I. Berti1, S. Martelossi1, I. Bruno1, N. Giurici1 , S. Crovella1 and A. Ventura1, 2

(1) Department of Reproduction and Development Sciences, University of Trieste—IRCCS Burlo Garofolo, Trieste, Italy

(2) Clinica Pediatrica, Università di Trieste—IRCCS Burlo Garofolo, Via dell’Istria 65/1, 34134 Trieste, Italy

Received: 28 October 2007 Revised: 10 March 2008 Accepted: 17 March 2008 Published online: 11 June 2008

Cristina Serra | alfa
Further information:
http://www.burlo.trieste.it
http://www.springerlink.com/content/?k=Cannioto

More articles from Health and Medicine:

nachricht Penn vet research identifies new target for taming Ebola
12.01.2017 | University of Pennsylvania

nachricht The strange double life of Dab2
10.01.2017 | University of Miami Miller School of Medicine

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Designing Architecture with Solar Building Envelopes

Among the general public, solar thermal energy is currently associated with dark blue, rectangular collectors on building roofs. Technologies are needed for aesthetically high quality architecture which offer the architect more room for manoeuvre when it comes to low- and plus-energy buildings. With the “ArKol” project, researchers at Fraunhofer ISE together with partners are currently developing two façade collectors for solar thermal energy generation, which permit a high degree of design flexibility: a strip collector for opaque façade sections and a solar thermal blind for transparent sections. The current state of the two developments will be presented at the BAU 2017 trade fair.

As part of the “ArKol – development of architecturally highly integrated façade collectors with heat pipes” project, Fraunhofer ISE together with its partners...

Im Focus: How to inflate a hardened concrete shell with a weight of 80 t

At TU Wien, an alternative for resource intensive formwork for the construction of concrete domes was developed. It is now used in a test dome for the Austrian Federal Railways Infrastructure (ÖBB Infrastruktur).

Concrete shells are efficient structures, but not very resource efficient. The formwork for the construction of concrete domes alone requires a high amount of...

Im Focus: Bacterial Pac Man molecule snaps at sugar

Many pathogens use certain sugar compounds from their host to help conceal themselves against the immune system. Scientists at the University of Bonn have now, in cooperation with researchers at the University of York in the United Kingdom, analyzed the dynamics of a bacterial molecule that is involved in this process. They demonstrate that the protein grabs onto the sugar molecule with a Pac Man-like chewing motion and holds it until it can be used. Their results could help design therapeutics that could make the protein poorer at grabbing and holding and hence compromise the pathogen in the host. The study has now been published in “Biophysical Journal”.

The cells of the mouth, nose and intestinal mucosa produce large quantities of a chemical called sialic acid. Many bacteria possess a special transport system...

Im Focus: Newly proposed reference datasets improve weather satellite data quality

UMD, NOAA collaboration demonstrates suitability of in-orbit datasets for weather satellite calibration

"Traffic and weather, together on the hour!" blasts your local radio station, while your smartphone knows the weather halfway across the world. A network of...

Im Focus: Repairing defects in fiber-reinforced plastics more efficiently

Fiber-reinforced plastics (FRP) are frequently used in the aeronautic and automobile industry. However, the repair of workpieces made of these composite materials is often less profitable than exchanging the part. In order to increase the lifetime of FRP parts and to make them more eco-efficient, the Laser Zentrum Hannover e.V. (LZH) and the Apodius GmbH want to combine a new measuring device for fiber layer orientation with an innovative laser-based repair process.

Defects in FRP pieces may be production or operation-related. Whether or not repair is cost-effective depends on the geometry of the defective area, the tools...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

12V, 48V, high-voltage – trends in E/E automotive architecture

10.01.2017 | Event News

2nd Conference on Non-Textual Information on 10 and 11 May 2017 in Hannover

09.01.2017 | Event News

Nothing will happen without batteries making it happen!

05.01.2017 | Event News

 
Latest News

Multiregional brain on a chip

16.01.2017 | Power and Electrical Engineering

New technology enables 5-D imaging in live animals, humans

16.01.2017 | Information Technology

Researchers develop environmentally friendly soy air filter

16.01.2017 | Power and Electrical Engineering

VideoLinks
B2B-VideoLinks
More VideoLinks >>>