National Medical Research Center for Children’s Health, Ministry of Health of the Russian Federation; Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of the Russian Federation
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Maksim M. Lokhmatov
National Medical Research Center for Children’s Health, Ministry of Health of the Russian Federation; Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of the Russian Federation
The authors present current data on the etiology, pathogenesis, clinical manifestations of celiac disease in children of different ages, associated diseases, laboratory and instrumental diagnostics, diet therapy, additional treatment methods, vaccination, and follow-up of children with celiac disease based on the developed clinical guidelines “Celiac Disease. Children”.
25 May 2023 in Experimental and Clinical Gastroenterology
Inflammatory bowel disease (IBD) is a group of severe systemic diseases with a multiple intestinal and extraintestinal manifestations (EIM). EIM can affect any organ systems, determine the course, therapy and prognosis of the underlying disease. The frequency of EIM (6–80%) differs significantly in studies depending on the cohort of patients (number, age of patients, IBD phenotype). In 6–10% of children EIM are the first symptoms of the disease. The classification of EIM most often depends on the activity of the disease in the intestine. The most commonly affected «target organs» in children and adults are joints, skin and mucous membranes, eyes, and the hepatobiliary system. Physical development delay is specific for children IBD, not always reversible. The article highlights the incidence of ulcerative colitis and Crohn’s disease EIM in children and adults, analyzes the basics of epidemiology, pathogenesis, clinical manifestations, approaches to the diagnosis and treatment of arthritis, growth disorders, mucocutaneous, ocular and hepatobiliary EIM of IBD in children. Therapy of EIM associated with IBD activity is aimed at controlling the underlying disease and includes a wide range of drugs, ФНОα antagonists are the most effective. The treatment protocols for other EIM are not standardized in either adult or pediatric practice and are significantly less successful.
Peutz-Jeghers syndrome is a relatively rare autosomal-dominant inheritance type disease characterized by multiple hamartomas in the gastrointestinal tract. Treatment of such patients is traditionally surgical, but nowadays, due to the introduction of new methods of intraluminal endoscopy, it is often possible to avoid open abdominal operations, diagnose and remove the hamartomatous polyps in a minimally invasive way. The aim of this article is to demonstrate the diagnostic and surgical capabilities of modern intraluminal endoscopy for the treatment of patients with multiple hereditary gastrointestinal polyposis as shown on our own clinical observations. The technique of deep single balloon enteroscopy in conjunction with standard routine endoscopic manipulations allows to perform a total examination of the whole gastrointestinal tract and, if necessary, to remove almost all epithelial neoplasia, which certainly has a positive impact on the quality of the patient’s life.
22 May 2023 in Experimental and Clinical Gastroenterology