The purpose of the article is to demonstrate a clinical case of Crohn’s disease in an 8-year-old child. Materials and methods: The given clinical example is a case of a non-classical variant of the course of Crohn’s disease in an 8-year-old child who debuted with an upper respiratory tract lesion in combination with abdominal pain against the background of long courses of antibacterial therapy. Conclusion: This clinical case demonstrates the complexity of the diagnostic search, the need for careful history collection and differential diagnosis.

Study Objective: To assess the relation between clinical manifestations of gastroesophageal reflux disease (GERD) and specific gastrointestinal (GIT) motility in children using electrogastroenterography (EGEG). Study Design: observational comparative study. Materials and Methods. We examined 55 children at the age of 7 to 17 years old with confirmed GERD. All patients underwent EGEG. In order to study the specificity of GIT motility and evacuation in patients with traditional signs of GERD, we compared complaints with fasting and postprandial EGEG results. Complaints included heartburn, belching, nausea, and vomiting. Study Results. The study made it possible to identify statistically significant correlations between clinical manifestations of GERD in children and EGEG results. Patients complaining of fasting heartburn had electric activity (Р(I)/PS, %) at ileum frequencies that was significantly lower than in children who did not complain of heartburn (р = 0.033); these changes evidence impaired ileum motility. P(I)/P(I + 1) jejunum /ileum ratio in patients with heartburn was significantly higher than without heartburn (р = 0.043), thus evidencing dislocated motility in these GIT sections. Children with fasting belching demonstrated a significant increase in the rhytmicity coefficient (Kritm) at the frequencies of the duodenum, jejunum and ileum (р = 0.042, р = 0.035, р = 0.036, respectively), thus evidencing non-propulsive contractions in these GIT sections. Patients with postprandial nausea, P(I)/P(I + 1) duodenum/ jejunum was significantly lower than in patients without complaints (р = 0.029). In children with fasting vomiting, Р(I)/PS, % at the stomach and duodenum frequencies was significantly higher than in children who did not have this problem (р = 0.028, р = 0.036, respectively); therefore, motility in these sections was increased. Patients complaining of vomiting demonstrated higher P(I)/P(I + 1) duodenum/ jejunum (р = 0.048). In patients with vomiting, Kritm in all GIT sections was significantly lower than in children not complaining of vomiting. Conclusion. Children with GERD who complained of vomiting and belching demonstrated the highest number of significant changes in fasting EGEG results, namely Р(I)/PS, % at the stomach and duodenum frequencies; and Kritm of all GIT sections. These changes evidence impaired motility, its incoordination, non-propulsive contractions, justifying prescription of medicines that can correct impaired motility. Keywords: gastroesophageal reflux disease, motility, gastrointestinal tract, peripheral electrogastroenterography, children.

Objective: To evaluate parental attitudes towards vaccination in children with inflammatory bowel disease (IBD), assess the level of adherence to immunization schedules, and identify key barriers hindering vaccination. Materials and Methods: A comparative survey was conducted involving 215 respondents, divided into an IBD group (109 parents of children with IBD) and a control group (106 parents of healthy children). The majority of respondents were mothers (96%) with higher education (81% and 79%, respectively) residing in a major metropolitan area. We assessed demographic data, vaccination history of both children and parents, sources of medical information, and reasons for vaccine refusal. Results: Routine vaccination coverage in children under 6 years of age was high and comparable in both groups (>93%). The majority of parents in the IBD group (n = 68; 62%) expressed a positive attitude towards vaccination. However, following the onset of IBD, only 24 (22%) continued vaccination, while 85 (78%) reported a categorical refusal to continue immunization. It was found that parents tend to misinterpret normal post-vaccination reactions as vaccine complications. A significant factor contributing to refusal is the lack of information from attending physicians and reliance on the Internet as a primary information source. Additionally, low rates of adult revaccination were noted, with over 30% of parents in both groups not being vaccinated in adulthood. Conclusions: The low vaccination rate in children with IBD after disease onset is driven not by initial anti-vaccination sentiment, but by acquired fears and a lack of professional communication from primary care providers and specialists. Improving immunization coverage requires the active implementation of educational programs for parents regarding vaccine safety during immunosuppressive therapy, as well as the development of specific guidelines for attending physicians.

Coeliac disease (CD) is a gluten-dependent inflammatory disease of the small bowel that affects up to 1% of the global population. Herein, the presence of ulcers, erosions, or strictures in the duodenum for non-advanced cases of CD is a rarity. Case report: We present a clinical case of a 17-year-old girl, who from the age of 9, had suffered from erosive Helicobacter pylori (HP)-associated gastritis and erosive duodenitis. At 16, she was diagnosed with a duodenal ulcer, complicated by cicatricial deformity of the bulb. While an atypical course in the development of the disease had led to the initial delay in diagnosis, a serum study and an intestinal biopsy confirmed CD. Discussion: A recent study found an elevated rate of peptic ulcer disease in patients with CD. From literature searches, comorbid HP infection and CD have indeed been widely reported, whereas cases highlighting the prevalence of CD-associated peptic ulcers have been observed and reported in only a few instances. Consequently, greater awareness is warranted and must be exercised for identifying the origins of ulcerative lesions that may be CD-related or -derived.

Objective. Examination of schoolchildren in Moscow using a specially designed questionnaire to identify children at risk of developing celiac disease. Patients and methods. The study enrolled 3070 Moscow schoolchildren aged 7–18 years old. Serological and genetic examinations were performed in 42 children at risk for celiac disease, including determination of IgA and IgE to wheat, IgA and IgG to tissue transglutaminase, and IgA to endomysium. Molecular HLA testing for alleles that predispose to celiac disease was conducted. Endoscopic and morphological diagnostics were performed when indicated. Results. The risk group for celiac disease amounted to 10.2% of all schoolchildren surveyed. According to the results of the questionnaire, children in the risk group significantly more often had abdominal pain, excess gas, bloating, flatulence, dyspeptic complaints (diarrhea, constipation, vomiting), asthma attacks or other forms of allergies, headache, joint or body pain, fatigue and weakness, mood swings, depression, anxiety, or episodes of emotional arousal. Changes in height, weight, delayed physical or sexual development, dental enamel defects, and skin rashes were also noted. Of the 42 children in the risk group, the DQ2 heterodimer was detected in 13 (31%) children, the DQ8 heterodimer – in 2 (4.8%), and a combination of DQ2 and DQ8 heterodimers – in 1 (2.4%). Thus, characteristic HLA haplotypes were identified in 38% of the examined children. Three children had IgA antibodies to tissue transglutaminase (at >10 norm) and IgA anti-endomysium antibody titers. Conclusion. The method of questioning by means of a specially designed questionnaire for school-age children allows to identify individuals at risk of developing celiac disease. According to serological, genetic, endoscopic, and morphological investigations, the incidence of celiac disease among children at risk was 7.1%. The prevalence of celiac disease among school-age children in Moscow corresponds to global trends, amounting to 0.7%. Key words: questionnaire, gluten-free diet, cereals, gluten intolerance, celiac disease, children