Внекишечные проявления воспалительных заболеваний кишечника у детей

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.

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