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Research Article

ОБЗОР

REVIEW

Внекишечные проявления воспалительных заболеваний кишечника у детей

Extraintestinal manifestations in infl ammatory bowel diseases in children, a modern view of the problem

https://orcid.org/0000-0003-3364-610X

Яблокова

Е. А.

Yablokova

E. A.

Яблокова Екатерина Александровна, к. м. н., ведущий научный сотрудник отдела педиатрии; доцент кафедры детских болезней КИДЗ им. Н. Ф. Филатова

Большая Серпуховская, 62, Москва, 115093, Россия

ул. Трубецкая, д. 8 стр. 2, Москва, 199991, Россия

Ekaterina A. Yablokova, MD, PhD, MSc (Medicine), Leading Researcher of the Department of Pediatrics; associate professor of the Department of Children’s Diseases, Filatov Clinical Institute

B. Serpukhovskaya, 62, Moscow, 115093, Russia

8–2 Trubetskaya str. Moscow, 119991, Russia

https://orcid.org/0000-0001-7756-7687

Джабарова

А. К.

Dzhabarova

A. K.

Джабарова Аида Каримовна, студентка 6 курса лечебного факультета

Россия, ул. Льва Толстого, д. 6–8, Санкт-Петербург, 197022, Россия

Aida K. Dzhabarova, 6th year student of the Faculty of Medicine

6–8 Lva Tolstogo St., 197022, St. Petersburg, 197022, Russia

https://orcid.org/0000-0002-8305-7592

Лохматов

М. М.

Lokhmatov

M. M.

Лохматов Максим Михайлович, д. м. н., профессор, зав. отделением эндоскопических исследований; профессор кафедры детской хирургии урологии и андрологии педиатрического факультета

ул. Трубецкая, д. 8 стр. 2, Москва, 199991, Россия

Maksim M. Lokhmatov, MD, PhD, Dr Sci, Professor, head of the Department of endoscopic examinations; professor of the Department of pediatric surgery, urology and uroandrology

8–2 Trubetskaya str. Moscow, 119991, Russia

https://orcid.org/0000-0001-9257-0171

Горелов

А. В.

Gorelov

A. V.

Горелов Александр Васильевич, академик РАН, д. м. н., профессор кафедры детских болезней КИДЗ им. Н. Ф. Филатова; зам. директора по научной работе

ул. Трубецкая, д. 8 стр. 2, Москва, 199991, Россия

Новогиреевская ул., д. 3А, Москва, 111123, Россия

Aleksandr V. Gorelov, MD, PhD, DSc (Medicine), Аcademician of the Russian Academy of Sciences Professor, Professor of the Department of Childhood Diseases, N. F. Filatov Institute of Child Health; Director for Research

8–2 Trubetskaya str. Moscow, 119991, Russia

3A, Novogireevskaya str. Moscow, 111123, Russia

https://orcid.org/0000-0001-7516-5756

Крутихина

С. Б.

Krutikhina

S. B.

Крутихина Светлана Борисовна, к. м. н., ассистент кафедры детских болезней КИДЗ им. Н. Ф. Филатова

ул. Трубецкая, д. 8 стр. 2, Москва, 199991, Россия

Svetlana B. Krutikhina, MD, PhD, Associate Professor, Department of Childhood Diseases, N. F. Filatov Institute of Child Health

8–2 Trubetskaya str. Moscow, 119991, Russia

https://orcid.org/0000-0003-3441-4626

Ерохина

М. И.

Erokhina

M. I.

Ерохина Мария Ильинична, заведующая отделением гастроэнтерологии; научный сотрудник отдела наследственных и метаболических болезней

Большая Серпуховская, 62, Москва, 115093, Россия

Maria I. Erokhina MD., Head of the Department of Gastroenterology

B. Serpukhovskaya, 62, Moscow, 115093, Russia

https://orcid.org/0000-0003-3332-5090

Чибрина

Е. В.

Chibrina

E. V.

Чибрина Елена Владимировна, к. м. н., врач отделения гастроэнтерологии; научный сотрудник отдела педиатрии

Большая Серпуховская, 62, Москва, 115093, Россия

Elena V. Chibrina MD., MD, PhD, MSc (Medicine), gastroenterologist

B. Serpukhovskaya, 62, Moscow, 115093, Russia

https://orcid.org/0000-0001-9536-5819

Римская

А. М.

Rimskaya

A. M.

Римская Алена Михайловна, аспирант кафедры детских болезней КИДЗ им. Н. Ф. Филатова

ул. Трубецкая, д. 8 стр. 2, Москва, 199991, Россия

Alena M. Rimskaya, MD, graduate student of the Department of Childhood Diseases, N. F. Filatov Institute of Child Health

8–2 Trubetskaya str. Moscow, 119991, Russia

https://orcid.org/0000-0001-7308-7280

Хавкин

А. И.

Khavkin

A. I.

Хавкин Анатолий Ильич, д. м. н., профессор, руководитель Московского областного центра детской гастроэнтерологии и гепатологии, главный научный сотрудник отдела педиатрии

Большая Серпуховская, 62, Москва, 115093, Россия

ул. Талдомская, д. 2, Москва, 125412, Россия

г. Белгород, ул. Победы, д. 85 к.13, 308015, Россия

Anatoly I. Khavkin, MD, PhD, DSc (Medicine), Professor, Head of the Moscow Regional Center for Pediatric Gastroenterology, Hepatology and Abdominal Surgery

B. Serpukhovskaya, 62, Moscow, 115093, Russia

2, Taldomskaya str., Moscow, 125412, Russia

85, st. Pobedy, Belgorod, 308015, Russia

gastropedclin@gmail.com

ГБУЗ МО «Научно-исследовательский клинический институт детства» Министерства здравоохранения Московской области; ФГАОУ ВО «Первый Московский государственный медицинский университет имени И. М. Сеченова» Минздрава Российской Федерации (Сеченовский Университет)РоссияResearch Clinical Institute of Childhood of the Moscow Region; First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University)Russian Federation

ФГБОУ ВО Первый Санкт-Петербургский государственный медицинский университет им. Акад. И.П. Павлова МЗ РФРоссияFirst Pavlov State Medical University of St. PetersburgRussian Federation

ФГАОУ ВО «Первый Московский государственный медицинский университет имени И. М. Сеченова» Минздрава Российской Федерации (Сеченовский Университет)РоссияFirst Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University)Russian Federation

ФГАОУ ВО «Первый Московский государственный медицинский университет имени И. М. Сеченова» Минздрава Российской Федерации (Сеченовский Университет); ФБУН «Центральный научно-исследовательский институт эпидемиологии» РоспотребнадзораРоссияFirst Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University); Federal budget institute of science “Central research institute of epidemiology” of the Federal Service on Surveillance for consumer rights protection and human well-beingRussian Federation

ГБУЗ МО «Научно-исследовательский клинический институт детства» Министерства здравоохранения Московской областиРоссияResearch Clinical Institute of Childhood of the Moscow RegionRussian Federation

ГБУЗ МО «Научно-исследовательский клинический институт детства» Министерства здравоохранения Московской области; «Научно-исследовательский клинический институт педиатрии им. академика Ю. Е. Вельтищева» ФГАОУ ВО РНИМУ им. Н. И. Пирогова Минздрава России; ФГАОУ ВО Белгородский государственный национальный исследовательский университетРоссияResearch Clinical Institute of Childhood of the Moscow Region; Veltischev Research and Clinical Institute for Pediatrics and Pediatric Surgery of the Pirogov Russian National Research Medical University Research Clinical Institute of Pediatrics; Belgorod National Research UniversityRussian Federation

2023

25052023

11165177

2023

Яблокова Е.А., Джабарова А.К., Лохматов М.М., Горелов А.В., Крутихина С.Б., Ерохина М.И., Чибрина Е.В., Римская А.М., Хавкин А.И.

Yablokova E.A., Dzhabarova A.K., Lokhmatov M.M., Gorelov A.V., Krutikhina S.B., Erokhina M.I., Chibrina E.V., Rimskaya A.M., Khavkin A.I.

Данная работа распространяется под лицензией Creative Commons Attribution 4.0.

This work is licensed under a Creative Commons Attribution 4.0 License.

https://www.nogr.org/jour/article/view/2277

Воспалительные заболевания кишечника (ВЗК) — группа тяжелых системных заболеваний, для которых характерен широкий спектр кишечных и внекишечных проявлений (ВКП). Внекишечные проявления могут затрагивать все системы органов, определять течение, объем терапии и прогноз основного заболевания. Частота их (6–80%) значительно отличается в исследованиях в зависимости когорты больных (объем, возраст пациентов, фенотип ВЗК), у 6–10% детей ВКП являются первыми симптомами заболевания. Классификация ВКП чаще всего учитывает наличие или взаимосвязи с активностью заболевания в кишке. Наиболее часто поражаемые «органы- мишени» у детей и взрослых — суставы, кожа и слизистые оболочки, глаза и гепатобилиарная система. Нарушение физического развития специфично для течения детского ВЗК, не всегда обратимо. Статья освещает частоту ВКП язвенного колита и болезни Крона у детей и взрослых, разбирает основы эпидемиологии, патогенеза, клинических проявлений, подходы к диагностике и терапии артритов, нарушений роста, кожно- слизистых, глазных и гепатобилиарных внекишечных проявлений ВЗК у детей. Терапия ВКП, ассоциированных с активностью ВЗК, направлена на контроль основного заболевания и включает широкий круг препаратов, наиболее эффективными из которых являются антагонисты ФНО-α. Протоколы лечения остальных ВКП не стандартизированы ни во взрослой, ни в детской практике, и значительно менее успешны.

Inflammatory bowel disease (IBD) is a group of severe systemic diseases with a multiple intestinal and extraintestinal manifestations (EIM). EIM can affect any organ systems, determine the course, therapy and prognosis of the underlying disease. The frequency of EIM (6–80%) differs significantly in studies depending on the cohort of patients (number, age of patients, IBD phenotype). In 6–10% of children EIM are the first symptoms of the disease. The classification of EIM most often depends on the activity of the disease in the intestine. The most commonly affected «target organs» in children and adults are joints, skin and mucous membranes, eyes, and the hepatobiliary system. Physical development delay is specific for children IBD, not always reversible. The article highlights the incidence of ulcerative colitis and Crohn’s disease EIM in children and adults, analyzes the basics of epidemiology, pathogenesis, clinical manifestations, approaches to the diagnosis and treatment of arthritis, growth disorders, mucocutaneous, ocular and hepatobiliary EIM of IBD in children. Therapy of EIM associated with IBD activity is aimed at controlling the underlying disease and includes a wide range of drugs, ФНОα antagonists are the most effective. The treatment protocols for other EIM are not standardized in either adult or pediatric practice and are significantly less successful.

болезнь Кронавнекишечные проявлениявоспалительные заболевания кишечникадетиязвенный колит

childrenCrohn’s diseaseulcerative colitisIBDEIM

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The authors declare that there are no conflicts of interest present.