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 Photoactive bacteria bait may help in fight against MRSA infections
12.10.2018 | Purdue University

nachricht 15 emerging technologies that could reduce global catastrophic biological risks
10.10.2018 | Johns Hopkins Center for Health Security

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: Storage & Transport of highly volatile Gases made safer & cheaper by the use of “Kinetic Trapping"

Augsburg chemists present a new technology for compressing, storing and transporting highly volatile gases in porous frameworks/New prospects for gas-powered vehicles

Storage of highly volatile gases has always been a major technological challenge, not least for use in the automotive sector, for, for example, methane or...

Im Focus: Disrupting crystalline order to restore superfluidity

When we put water in a freezer, water molecules crystallize and form ice. This change from one phase of matter to another is called a phase transition. While this transition, and countless others that occur in nature, typically takes place at the same fixed conditions, such as the freezing point, one can ask how it can be influenced in a controlled way.

We are all familiar with such control of the freezing transition, as it is an essential ingredient in the art of making a sorbet or a slushy. To make a cold...

Im Focus: Micro energy harvesters for the Internet of Things

Fraunhofer IWS Dresden scientists print electronic layers with polymer ink

Thin organic layers provide machines and equipment with new functions. They enable, for example, tiny energy recuperators. In future, these will be installed...

Im Focus: Dynamik einzelner Proteine

Neue Messmethode erlaubt es Forschenden, die Bewegung von Molekülen lange und genau zu verfolgen

Das Zusammenspiel aus Struktur und Dynamik bestimmt die Funktion von Proteinen, den molekularen Werkzeugen der Zelle. Durch Fortschritte in der...

Im Focus: Dynamics of individual proteins

New measurement method allows researchers to precisely follow the movement of individual molecules over long periods of time

The function of proteins – the molecular tools of the cell – is governed by the interplay of their structure and dynamics. Advances in electron microscopy have...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

VideoLinks
Industry & Economy
Event News

5th International Conference on Cellular Materials (CellMAT), Scientific Programme online

02.10.2018 | Event News

Major Project: The New Silk Road

01.10.2018 | Event News

"Boston calling": TU Berlin and the Weizenbaum Institute organize a conference in USA

21.09.2018 | Event News

 
Latest News

Storage & Transport of highly volatile Gases made safer & cheaper by the use of “Kinetic Trapping"

15.10.2018 | Life Sciences

Graphene shows unique potential to exceed bandwidth demands of future telecommunications

15.10.2018 | Materials Sciences

Goldilocks principle in biology -- fine-tuning the 'just right' signal load

15.10.2018 | Agricultural and Forestry Science

VideoLinks
Science & Research
Overview of more VideoLinks >>>