ESPEYB15 9 Oncology and chronic disease Biologic agents in chronic inflammatory diseases: lights and shadows (3 abstracts)
9.11 Perianal pediatric Crohn disease is associated with a distinct phenotype and greater inflammatory burden
Assa A , Amitai M , Greer ML , Castro DA , Kuint RC , Martínez-León M , Herman-Sucharska I , Coppenrath E , Anupindi S , Towbin A , Moote D , Konen O , Pratt LT , Griffiths A & Turner D; ImageKids Study Group
Institute of Gastroenterology, Nutrition and Liver Disease, Schneider Children’s Medical Center of Israel, Sackler Faculty of Medicine, Israel
To read the full abstract: J Pediatr Gastroenterol Nutr. 2017;65:293-298
Growth deceleration and impaired pubertal growth spurt are common concerns in patients with early onset inflammatory bowel disease (IBD) (1-2). Previous studies confirmed the efficacy and safety of infliximab, an anti-tumor necrosis factor alpha (TNF-α) antibody, in achieving clinical remission in luminal Crohn’s disease (CD) and in facilitating linear growth (3). The present study describes in depth the specific characteristics of children with perianal CD (pCD), a sub-category of CD patients that appears to exhibit a higher level of inflammation. Previous studies reported a higher rate of intestinal resection in patients with pCD. As the authors state, the lack of this association in the present cohort could be linked to the currently recommended prompt start of anti-TNFa agents in the presence of perianal disease, that alters the natural history of the disease. This study reports reduced height Z-scores in children with pCD. It should be noted that height data were not correlated to the target height. Similarly, no data about growth velocity, pubertal stage and/or bone age of patients were available. For these reasons, it appears interesting to investigate in more detail the growth aspects in this sub-category of patients with IBD.
1. Mason A, Malik S, McMillan M, McNeilly JD, Bishop J, McGrogan P, Russell RK, Ahmed SF. A prospective longitudinal study of growth and pubertal progress in adolescents with inflammatory bowel disease. Horm Res Paediatr. 2015; 83: 45-54.
2. Church PC, Guan J, Walters TD, Frost K, Assa A, Muise AM, Griffiths AM. Infliximab maintains durable response and facilitates catch-up growth in luminal pediatric Crohn’s disease. Inflamm Bowel Dis. 2014; 20: 1177-1186.
3. Karlage RE, Wilson CL, Zhang N, Kaste S, Green DM, Armstrong GT, Robison LL, Chemaitilly W, Srivastava DK, Hudson MM, Ness KK. Validity of anthropometric measurements for characterizing obesity among adult survivors of childhood cancer: A report from the St. Jude Lifetime Cohort Study. Cancer. 2015; 121: 2036–2043.
Volume 15
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ESPE Yearbook of Paediatric Endocrinology
ISSN 1662-4009 (Online)
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