FOR EXTRAINTESTINAL MANIFESTATIONS OF INFL AMMATORY BOWEL DISEASE IN CHILDREN
Abstract
Inflammatory bowel disease (IBD) are systemic diseases with different intestinal and extra-intestinal manifestations (EIM). This fact can determin an examination plan and the disease course and prognosis. Up to 8.4% of children with IBD have EIM like the first symptom of the disease. The range of EIM of IBD in children is differ from that one of adult patients: rarer arthropathy and arthritis, skin and liver diseases, an extremely rare eye disease. The physical development disorder is a typical children's manifestation of the IBD, the “failure of the weight curve” is an early symptom of the IBD debut (82% of examined children), especially ulcerative colitis. The article discusses the clinical features and therapy of the most frequent extraintestinal manifestations of IBD in children: skin, mucous, eye diseases, axial and peripheral arthropathies, primary sclerosing cholangitis, physical, sexual development disorders, decreased bone mineral density. Most often, we observed patients with arthritis and primary sclerosing cholangitis - up to 12.5% of patients with active disease. A growth failure was observed in 20% of children with IBD debut, and remained in 9.7% children despite adequate anti-inflammatory therapy. Decreased bone mineral density in children with IBD observed in 30% cases (ISCD-recommendations). Extraintestinal manifestations are very important to make the early diagnosis of IBD without any intestinal symptoms. The pediatrician can suspect a systemic diseases course. EIMs adversely impact upon patients, quality of life and some can be life-threatening.
About the Authors
E. A. Yablokova
First Moscow state University n. a. I. M. Sechenov
Russian Federation
Russian Federation
A. V. Gorelov
First Moscow state University n. a. I. M. Sechenov
Russian Federation
Russian Federation
I. V. Sichinava
First Moscow state University n. a. I. M. Sechenov
Russian Federation
Russian Federation
E. V. Borisova
First Moscow state University n. a. I. M. Sechenov
Russian Federation
Russian Federation
E. Y. Polotnyanko
First Moscow state University n. a. I. M. Sechenov
Russian Federation
Russian Federation
M. I. Grammatopulo
First Moscow state University n. a. I. M. Sechenov
Russian Federation
Russian Federation
A. A. Kanshina
First Moscow state University n. a. I. M. Sechenov
Russian Federation
Russian Federation
References
1. Benchimol EA, Fortinsky KJ, Gozdyra P et al. Epidemiology of pediatric inflammatory bowel disease: a systematic review of international trends. Inflamm Bowel Dis. 2011;17:423-439.
2. Heyman MB, Kirschner BS, Gold BD et al. Children with earlyonset inflammatory bowel disease (IBD): analysis of a pediatric IBD consortium registry. J. Pediatr. 2005;146:35-40.
3. Потапов АС, Алиева ЭИ, Габрузская ТВ, Горелов АВ, Захарова ИН, Корниенко ЕА и др. Клиническая картина, диагностика и лечение язвенного колита у детей: Российский педиатрический консенсус (репринт). Вопросы современной педиатрии. 2013; 12 (3):1-9.
4. F. M. Ruemmele, G. Veres, K. L. Kolho, A. Griffiths, A. Levine, J. C. Escher et al. Consensus guidelines of ECCO/ESPGHAN on the medical management of pediatric Crohn's disease. Journal of Crohn's and Colitis. 2014. 8: 1179-1207.
5. Benchimol EI, Fortinsky KJ, Gozdyra P, Van den Heuvel M, Van Limbergen J, Griffiths AM. Epidemiology of pediatric inflammatory bowel disease: a systematic review of international trends. Inflamm Bowel Dis. 2011;17(1):423-39.
6. M. Harbord, V. Annese, S. R. Vavricka, M. Allez, M. Barreiro-de-Acosta et al. The first European Evidence-based consensus on extra-intestinal manifestations in inflammatory bowel disease. Journal of Crohn's and Colitis. 2016, 239-254.
7. Адлер Г. Болезнь Крона и язвенный колит. М.: ГЭОТАР-МЕД; 2001.
8. Беренс Р, Будерус Ш, Келлер КМ, фон дер Остен-Сален И. Болезнь Крона и язвенный колит у детей и подростков: практическое руководство. Под ред. АА Шептулина, СИ Ситкина. СПб.: Dr.Falk pharma GmbH; 2005.
9. Greenstein AJ et al. The extraintestinal complications of Crohn’s disease and ulcerative colitis: a study of 700 patients. Medicine. 1979; 55: 410-412.
10. Hyams JS. Extraintestinal manifestation of inflammatory bowel disease in children. J Pediatr Gastroenterol Nutr.1994;19:7-21.
11. Ott C, Schölmerich J. Extraintestinal manifestation and complication in IBD. Nat Rev Gastroenterol Hepatol. 2013;10(10): 585-95.
12. Белоусова Е. А. Язвенный колит и болезнь Крона. Тверь.: Триада; 2002.
13. Griffiths AM. Crohn’s disease. In: David, TJ (Hrsg.): Recent Advanсes in Paediatrics. Churchill Livigstone, Edinburgh, London, Melbourne; 1992: p.145-160.
14. Яблокова ЕА, Горелов АВ, Шевцова ГВ, Полотнянко ЕЮ, Грамматопуло МИ, Борисова ЕВ, и др. Внекишечные проявления воспалительных заболеваний кишечника у детей. Вопросы практической педиатрии. 2015; 10 (3):65-74.
15. Европейские рекомендации по диагностике и лечению болезни Крона, 2006 г. Клиническая фармакология и терапия.2007;16(1): 5-9.
16. Мелешкина АВ, Чебышева СН, Жолобова ЕС, Николаева МН. Суставной синдром при хронических воспалительных заболеваниях кишечника: взгляд ревматолога. Педиатрия. Симпозиум. 2014;1: 1-6.
17. Compston JE, Judd D, Crawley EO et al. Osteoporosis in patients with inflammatory bowel disease. Gut. 1987; 28: 410-415.
18. Лейшнер У. Аутоиммунные заболевания печени и перекрестный синдром. М.: Анахарсис; 2005.
19. Broom U, Glaumann H, Hellers H et al. Liver disease in ulcerative colitis: an epidemiological and follow-up study in country of Stockholm. Gut. 1994; 35: 84-89.
20. Wilschanski M, Chait P, Wade JA et al. Primary sclerosis cholangitis in 32 children: clinical laboratory and radiological features, with survival analysis. Hepatology. 1995; 22: 1415-1422.
21. Beuers U, Spengler U, Kruis W et al. Ursodeoxycholic acid for treatment of primary sclerosing cholangitis: A placebo-controlled trial. Hepatology. 1992; 16: 707-714.
22. Яблокова ЕА. Клинические особенности и нарушение минерализации костной ткани у детей с воспалительными заболеваниями кишечника: Автореф. дисс. … канд. мед. наук. М.; 2006.
23. Hildebrand H, Karlberg J, Kristiansson B. Longitudinal growth in children with inflammatory bowel disease. J Pediatr Gastroenterol Nutr. 1994;18: 165-173.
24. McCaffery TD, Nasr K, Lawrence AM et al. Severe growth retardation children with inflammatory bowel disease. Pediatrics. 1970;45: 386-393.
25. Evans M, Walker-Smith JA. Recording growth and development in children with inflammatory bowel disease.BMJ.1989; 289: 865-866.
26. Motil KJ, Grand RJ, Davis-Kraft L et al. Growth failure in pediatric inflammatory bowel disease. A prospective study. Gastroenterol. 1993;105: 681-691.
27. Allen DB. Glucocrticoid-associated growth failure: Mechanism and potential reversal. Endocrinology. 1998;8: 21-30.
28. Urne FU et al. Anthropometric status at the time of diagnosis in children with chronic inflammatory bowel disease. Gut. 2003; 52 (Suppl VI - 11th UEGW): A 105.
29. Boot AM, Bouquet J, Krenning EP et al. Bone mineral density and nutritional status in children with chronic inflammatory bowel disease. Gut.1998;42: 188-194.
30. Croft NM, Ho J et al. Decreased bone mineral density at diagnosis in paediatric inflammatory bowel disease. Gut. 2003; 52: A 21.
31. Majlingova S, Tomkova S. Evaluation of bone metabolism in children with IBD. Gut.2003; 52 (Suppl VI - 11th UEGW): A 107.
32. Jahnsen J, Falch JA, Mowinckel P et al. Bone mineral density in patients with inflammatory bowel disease: a population-based prospective two-year follow up study. Scand J Gastroenterol. 2004; 39 (2): 145-53.
33. Van der Sluis IM, Ridder MA et al. Reference data and body composition measured with dual energy x-ray absorbtiometry in white children and young adults. Arch Dis Child. 2002; 87: 341-347.
34. Gokhale R, Favus M et al. Bone mineral density assessment in children with inflammatory bowel disease. Gastroenterol. 1998;114: 902-911.
Review
For citations:
Yablokova E.A., Gorelov A.V., Sichinava I.V., Borisova E.V., Polotnyanko E.Y., Grammatopulo M.I., Kanshina A.A. FOR EXTRAINTESTINAL MANIFESTATIONS OF INFL AMMATORY BOWEL DISEASE IN CHILDREN. Experimental and Clinical Gastroenterology. 2016;(8):62-66. (In Russ.)
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