Introduction : The acute pancreatitis is a rare disease, but it has started to be diagnosed more often in children. Aim : The aim of the study was single-centre, retrospective analysis of the incidence, aetiology, and clinical course of acute pancreatitis in children. Material and...

Background. Insufficient vitamin D and calcium intake associated with the restricted intake of milk and dairy products can lead to poor health outcomes like malnutrition and abnormal bone mineralization. The aim of the study was to estimate the prevalence of primary and secondary lactose intolerance in children with IBD. Methods. The study included 107 patients (mean age 14.07±3.58 years; 46.7% boys) which includes 43 patients with Crohn’s disease (CD), 31 with ulcerative colitis (UC), and 33 children with functional abdominal pain (AP-FGID). We analysed the result of the hydrogen breath test with lactose loading, two single nucleotide polymorphisms of the LCT gene (LCT-13910CC and LCT-22018GG). The results were analysed with MedCalc Statistical Software. Results. Adult-type hypolactasia (ATH) was found in 31% of patients with IBD and 42.4% of AP-FGID (p=0.2). Lactose malabsorption (LM) was found in 27.9% of patients with CD, in 22.6% with UC, and in 24.2% with AP-FGID (p=0.8). Lactose intolerance (LI) was diagnosed in a similar percentage of patients in each group (p=0.9). Secondary LI in IBD patients does not depend on the location, duration, and activity of the disease and the number of relapses (p>0.05). The median time of lactose-free diet in CD was 10 months and in CU 24 months. Conclusions. The incidence of LI, LM, and ATH does not differ among children with IBD from the population.

Background: A diet restricted in dairy products can cause calcium and vitamin D deficiency and, secondarily, lead to malnutrition and low bone mass. The aim of the study was to determine the incidence hypocalcemia and vitamin D deficiency in children with inflammatory bowel diseases and lactose intolerance (LI). Material and Methods: A total of 107 patients were enrolled to the study (mean age 14.07 ± 3.58 years; 46.7% boys): 43 with Crohn’s disease (CD), 31 with ulcerative colitis (UC), and 33 with functional abdominal pain (AP-FGID). Hydrogen breath test with lactose and laboratory tests to assess the calcium-phosphate metabolism were performed in all patients. The results of densitometry were interpreted in 37 IBD patients. Results: LI was diagnosed in 23.2% patients with CD, 22.6% with UC, and 21.2% children with AP-FGID, (p = 0.9). Moreover, 9.5% patients with CD, in 21.4% with UC, and in 51.5% with AP-FGID had optimal concentration of 25(OH)D (p = 0.0002). Hypocalcemia was diagnosed in 21% of patients with CD, 16.1% with UC patients, AP-FGID patients had normal calcium levels (p = 0.02). There was no difference in concentrations of total calcium, phosphorus, and 25(OH)D between patients on low-lactose diet and normal diet (p > 0.05). BMD Z-score ≤ −1 SD was obtained by 12 CD patients (48%), and 6 with UC (50%). Conclusion: The use of a low-lactose diet in the course of lactose intolerance in children with inflammatory bowel diseases has no effect on the incidence of calcium-phosphate disorders and reduced bone mineral density.

Oxidative stress (OS) has been recently implicated in the disease pathogenesis in inflammatory bowel disease (IBD). The aim of the study was to evaluate oxidative and antioxidative stress status and the risk of the atherosclerotic process in children with IBD and functional gastrointestinal disorders (FGID). The prospective study included a group of 71 children during a period of 2 years. In all children, laboratory tests were performed and intima-media complex in the carotid artery was measured (IMC). Low values of OS were more frequent in children with IBD than in the FGID group. The average concentration of oxidized lipoprotein with average density (oxLDL) was lower in patients with IBD. Among patients with IBD, higher concentrations of oxLDL were recorded in patients with longer-duration disease and with higher concentrations of total cholesterol. In the IBD group, more often, higher concentrations of anti-oxLDL were recorded among patients with longer-duration disease. The obtained results did not support the hypothesis of total antioxidant capacity depletion and greater overall OS in patients with IBD. Patients with IBD with a longer duration of the disease have higher concentrations of oxLDL and anti-oxLDL.

BackgroundIn recent years, an increased number of children infected with bacteria of the Campylobacter type is observed. It is estimated that approximately in 1% of the population of Europe and of the United States Campylobacter infection occurs.Aim of studyThe aim of the study was a retrospective analysis of the clinical course of Campylobacter infection in children according to the age and associated infections.Materials and methodsThe retrospective analysis included 71 children (mean age 2 years) hospitalized in the Gastroenterology Unit between Jan 2008 and Dec 2010. In all children with the Campylobacter infection clinical symptoms, laboratory tests and associated infections were analyzed.ResultsCampylobacter infection was diagnosed in 71 children (42 boys), which represented 5.28% of the children among 1343 patients hospitalized because of vomiting or diarrhea. In 22 children the Campylobacter infection was accompanied by other gastrointestinal infections (enteropathogenic strains of E. coli, Rotavirus, Salmonella). Mean duration of hospitalization was 7.24 days. According to age, analyzing the clinical symptoms of campylobacteriosis statistically significant incidence of watery diarrhea in children over 1 year of age has been shown, and abdominal pain in children over 3 years of age has been demonstrated. Diarrhea with blood occurred most frequently in children under 1 year of age.ConclusionsDue to the observed increasing incidence of Campylobacter infections it seems to be reasonable to take feces inoculation in children with diarrhea to 3 years of age, especially in the presence of bloody feces

Background: Most published pediatric guidelines on food allergy highlight the importance of nutritional counseling and dietary adequacy to avoid either growth retardation or nutritional deficiencies. The aim of the study was an assessment of the nutritional status of children with IgE-mediated food allergies. Material and method: 45 patients with newly diagnosed food allergy (FA) and 33 healthy controls were analyzed (aged 6 to 72 months, 60.2% boys). The nutritional status was assessed using anthropometric measurements (body weight and length) and serum laboratory tests. The results were analyzed with the Statistica 12 software (Tulsa, OK, USA). Results: 82%, 40%, 8.8%, and 6.6% of the studied children demonstrated allergy to hen’s egg, cow’s milk, pork meat, and wheat/rye, respectively. Z-score BMI < −2SD was more often found in the FA subjects under 30 months of age than in the controls (p = 0.04). As many as 77.8% of the FA subjects and 78.8% of the controls were of normal height (hSDS: −0.23 ± 1.74 and −0.31 ± 1.49, respectively, p = 0.8). Retinol binding protein four serum concentration was significantly lower in the FA group (17.01 ± 3.84 mg/L) than in the controls (20.47 ± 4.87 mg/L, p < 0.001). No statistically significant differences were observed between the FA group and the controls (either in the younger or the older age group) (p > 0.05) for the serum concentrations of total protein, total cholesterol, thyroxin-binding prealbumin (TBPA), 25(OH)D, hemoglobin level or white blood cells. Conclusions: In patients under 30 months of age, one of the symptoms of food allergy may be body weight deficiency, while short stature is less common at the time of diagnosis.