Problemi speciali
Malattie infiammatorie croniche intestinali: epidemiologia e presentazione clinica
CHRONIC INFLAMMATORY BOWEL DISEASES: EPIDEMIOLOGY AND CLINICAL PRESENTATION IN PAEDIATRIC AGE
Matteo Bramuzzo, Margherita Londero, Gabriele Cont, Stefano Martelossi, Marzia Lazzerini
Clinica Pediatrica, IRCCS “Burlo Garofolo”, Trieste
Aprile 2009 - pagg. 232 -237
Abstract
Background: Chronic inflammatory bowel diseases (IBD) are an increasing cause of morbidity in paediatric age both in the western countries and in the developing ones and, due to frequent aspecificity of their symptoms, are often diagnosed with a certain delay.
Methods and materials: Through the analysis of the literature, we highlight the most recent epidemiological data and through some case reports we suggest some elements that can help paediatricians to suspect the disease and to facilitate the diagnosis.
Results: Italian incidence of IBD in children is 1.39:100,000 with the peak of incidence between the age of 10 and 12; bloody diarrhoea and abdominal pain for ulcerative colitis and weight loss for Crohn’s disease are the most frequent symptoms at the presentation of the disease.
Conclusions: IBD is a group of frequent diseases and the paediatrician must suspect them even in absence of evident gastrointestinal symptoms.
Methods and materials: Through the analysis of the literature, we highlight the most recent epidemiological data and through some case reports we suggest some elements that can help paediatricians to suspect the disease and to facilitate the diagnosis.
Results: Italian incidence of IBD in children is 1.39:100,000 with the peak of incidence between the age of 10 and 12; bloody diarrhoea and abdominal pain for ulcerative colitis and weight loss for Crohn’s disease are the most frequent symptoms at the presentation of the disease.
Conclusions: IBD is a group of frequent diseases and the paediatrician must suspect them even in absence of evident gastrointestinal symptoms.
Classificazione MeSH
Bibliografia
1. Castro M, Papadatou B, Baldassare M, et
al. Inflammatory bowel disease in children
and adolescents in Italy: data from the pediatric
national IBD register (1996-2003). Inflamm
Bowel Dis 2008;14:1246-52.
2. Newby EA, Croft NM, Green M, et al. Natural history of paediatric inflammatory bowel diseases over a 5-year follow-up: a retrospective review of data from the register of paediatric inflammatory bowel diseases. J Pediatr Gastroenterol Nutr 2008;46:539-45.
3. Diefenbach KA, Breuer CK. Pediatric inflammatory bowel disease. World J Gastroenterol 2006;12:3204-12.
4. Russel MG. Changes in the incidence of inflammatory bowel disease: what does it mean? Eur J Intern Med 2000;11:191-6.
5. Griffiths AM. Specificities of inflammatory bowel disease in childhood. Best Pract Res Clin Gastroenterol 2004;18:509-23.
6. Pappa HM, Semrin G, Walzer TR, Grand RJ. Pediatric inflammatory bowel disease. Curr Opin Gastroenterol 2004;20:33-40.
7. Heyman MB, Kirshner BS, Gold BD, et al. Children with early onset inflammatory bowel disease (IBD): analysis of a pediatric IBD consortium registry. J Pediatr 2005;146:35-40.
8. Cannioto Z, Berti I, Martelossi S, et al. IBD and IBD mimicking enterocolitis in children younger than 2 years of age. Eur J Pediatr 2009;168:149-55.
9. Loftus EV Jr, Sandborn WJ. Epidemiology of inflammatory bowel disease. Gastroenterology 2002;35:144-8.
10. Karban A, Itay M, Davidovich O, et al. Risk factor for perianal Crohn’s disease: the role of genotype, phenotype, and ethnicity. Am J Gastroenterol 2007;102:1702-8.
11. Pozler O, Maly J, Bonova O, et al. Incidence of Crohn disease in the Czech Republic in the years 1990 to 2001 and assessment of pediatric population with inflammatory bowel disease. J Pediatr Gastroenterol Nutr 2006;42: 186-9.
12. Sood A, Midha V, Sood N, Bhatia AS, Avasthi G. Incidence and prevalence of ulcerative colitis in Punjab, North India. Gut 2003;52: 1587-90.
13. Ventura A. La Pagina gialla. Medico e Bambino 2008;27:11-2.
14. Differentiating Ulcerative colitis from Crohn disease in children and Young Adults: Report of a Working Group of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition and the Crohn’s and Colitis Foundation of America. J Pediatr Gastroenterol Nutr 2007;44:653-64.
15. D’Incà R, Dal Pont E, Di Leo V, et al. Calprotectin and lactoferrin in the assessment of intestinal inflammation and organic disease. Int J Colorectal Dis 2007;22:429-37.
16. Berni Canani R, Passaro M, Puzone C. Utilità diagnostica del dosaggio della calprotectina fecale in età pediatrica. Medico e Bambino 2009;28:239-42.
17. Garcia Sanchez Mdel V, Gonzales R, Iglesias Flores E, et al. Diagnostic value of fecal calprotectin in predicting an abnormal colonoscopy. Med Clin (Barc) 2006;127:41-6.
18. Inflammatory Bowel Disease Working Group of ESPGHAN. Inflammatory bowel disease in children and adolescents: recommendations for diagnosis-the Porto criteria. J Pediatric Gastroenterol Nutr 2005;41:1-7.
2. Newby EA, Croft NM, Green M, et al. Natural history of paediatric inflammatory bowel diseases over a 5-year follow-up: a retrospective review of data from the register of paediatric inflammatory bowel diseases. J Pediatr Gastroenterol Nutr 2008;46:539-45.
3. Diefenbach KA, Breuer CK. Pediatric inflammatory bowel disease. World J Gastroenterol 2006;12:3204-12.
4. Russel MG. Changes in the incidence of inflammatory bowel disease: what does it mean? Eur J Intern Med 2000;11:191-6.
5. Griffiths AM. Specificities of inflammatory bowel disease in childhood. Best Pract Res Clin Gastroenterol 2004;18:509-23.
6. Pappa HM, Semrin G, Walzer TR, Grand RJ. Pediatric inflammatory bowel disease. Curr Opin Gastroenterol 2004;20:33-40.
7. Heyman MB, Kirshner BS, Gold BD, et al. Children with early onset inflammatory bowel disease (IBD): analysis of a pediatric IBD consortium registry. J Pediatr 2005;146:35-40.
8. Cannioto Z, Berti I, Martelossi S, et al. IBD and IBD mimicking enterocolitis in children younger than 2 years of age. Eur J Pediatr 2009;168:149-55.
9. Loftus EV Jr, Sandborn WJ. Epidemiology of inflammatory bowel disease. Gastroenterology 2002;35:144-8.
10. Karban A, Itay M, Davidovich O, et al. Risk factor for perianal Crohn’s disease: the role of genotype, phenotype, and ethnicity. Am J Gastroenterol 2007;102:1702-8.
11. Pozler O, Maly J, Bonova O, et al. Incidence of Crohn disease in the Czech Republic in the years 1990 to 2001 and assessment of pediatric population with inflammatory bowel disease. J Pediatr Gastroenterol Nutr 2006;42: 186-9.
12. Sood A, Midha V, Sood N, Bhatia AS, Avasthi G. Incidence and prevalence of ulcerative colitis in Punjab, North India. Gut 2003;52: 1587-90.
13. Ventura A. La Pagina gialla. Medico e Bambino 2008;27:11-2.
14. Differentiating Ulcerative colitis from Crohn disease in children and Young Adults: Report of a Working Group of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition and the Crohn’s and Colitis Foundation of America. J Pediatr Gastroenterol Nutr 2007;44:653-64.
15. D’Incà R, Dal Pont E, Di Leo V, et al. Calprotectin and lactoferrin in the assessment of intestinal inflammation and organic disease. Int J Colorectal Dis 2007;22:429-37.
16. Berni Canani R, Passaro M, Puzone C. Utilità diagnostica del dosaggio della calprotectina fecale in età pediatrica. Medico e Bambino 2009;28:239-42.
17. Garcia Sanchez Mdel V, Gonzales R, Iglesias Flores E, et al. Diagnostic value of fecal calprotectin in predicting an abnormal colonoscopy. Med Clin (Barc) 2006;127:41-6.
18. Inflammatory Bowel Disease Working Group of ESPGHAN. Inflammatory bowel disease in children and adolescents: recommendations for diagnosis-the Porto criteria. J Pediatric Gastroenterol Nutr 2005;41:1-7.
Corrispondenza: bramuzzo@tiscalinet.it