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 New discoveries predict ability to forecast dementia from single molecule
12.12.2018 | UT Southwestern Medical Center

nachricht Pain: Perception and motor impulses arise in the brain independently of one another
12.12.2018 | Technische Universität München

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: An energy-efficient way to stay warm: Sew high-tech heating patches to your clothes

Personal patches could reduce energy waste in buildings, Rutgers-led study says

What if, instead of turning up the thermostat, you could warm up with high-tech, flexible patches sewn into your clothes - while significantly reducing your...

Im Focus: Lethal combination: Drug cocktail turns off the juice to cancer cells

A widely used diabetes medication combined with an antihypertensive drug specifically inhibits tumor growth – this was discovered by researchers from the University of Basel’s Biozentrum two years ago. In a follow-up study, recently published in “Cell Reports”, the scientists report that this drug cocktail induces cancer cell death by switching off their energy supply.

The widely used anti-diabetes drug metformin not only reduces blood sugar but also has an anti-cancer effect. However, the metformin dose commonly used in the...

Im Focus: New Foldable Drone Flies through Narrow Holes in Rescue Missions

A research team from the University of Zurich has developed a new drone that can retract its propeller arms in flight and make itself small to fit through narrow gaps and holes. This is particularly useful when searching for victims of natural disasters.

Inspecting a damaged building after an earthquake or during a fire is exactly the kind of job that human rescuers would like drones to do for them. A flying...

Im Focus: Topological material switched off and on for the first time

Key advance for future topological transistors

Over the last decade, there has been much excitement about the discovery, recognised by the Nobel Prize in Physics only two years ago, that there are two types...

Im Focus: Researchers develop method to transfer entire 2D circuits to any smooth surface

What if a sensor sensing a thing could be part of the thing itself? Rice University engineers believe they have a two-dimensional solution to do just that.

Rice engineers led by materials scientists Pulickel Ajayan and Jun Lou have developed a method to make atom-flat sensors that seamlessly integrate with devices...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

VideoLinks
Industry & Economy
Event News

ICTM Conference 2019: Digitization emerges as an engineering trend for turbomachinery construction

12.12.2018 | Event News

New Plastics Economy Investor Forum - Meeting Point for Innovations

10.12.2018 | Event News

EGU 2019 meeting: Media registration now open

06.12.2018 | Event News

 
Latest News

Magic number colloidal clusters

13.12.2018 | Life Sciences

UNLV study unlocks clues to how planets form

13.12.2018 | Physics and Astronomy

Live from the ocean research vessel Atlantis

13.12.2018 | Earth Sciences

VideoLinks
Science & Research
Overview of more VideoLinks >>>