Inflammatory Bowel Disease in Childhood and Adolescence: Diagnosis and Treatment.
Background: The incidence of inflammatory bowel disease (IBD) in childhood and adolescence is 5-11 cases per 100 000 persons per year, corresponding to a new diagnosis of IBD in 800-1470 patients in Germany each year. Methods: This review is based on pertinent publications retrieved by a selective s...
| Publicado en: | Deutsches Ärzteblatt International Vol. 114; no. 19; pp. 331 - 347 |
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| Autores principales: | , , , , |
| Formato: | Journal Article |
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Deutscher Aerzte-Verlag GmbH
5/12/2017
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=123724477&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 123724477 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 18660452 5F0N jtl: Deutsches Ärzteblatt International issn: 18660452 maglogo: N pubinfo: dt: 5/12/2017 vid: 114 iid: 19 pid: 25312 pub: Deutscher Aerzte-Verlag GmbH artinfo: ui: 123724477 10.3238/arztebl.2017.0331 123724477 ppf: 331 ppct: 16 formats: fmt: @attributes: type: P tig: atl: Inflammatory Bowel Disease in Childhood and Adolescence: Diagnosis and Treatment. aug: au: Däbritz, Jan Gerner, Patrick Enninger, Axel Claßen, Martin Radke, Michael affil: Department of Pediatrics, University Hospital Rostock sug: ab: Background: The incidence of inflammatory bowel disease (IBD) in childhood and adolescence is 5-11 cases per 100 000 persons per year, corresponding to a new diagnosis of IBD in 800-1470 patients in Germany each year. Methods: This review is based on pertinent publications retrieved by a selective search in PubMed, including guidelines from Germany and abroad. Results: Children and adolescents with IBD often have extensive involvement and an aggressive course of disease. Nonetheless, infliximab and adalimumab are the only biological agents that have been approved for this group of patients. In Crohn's disease, exclusive enteral nutrition is the treatment of first choice for inducing a remission. Patients with (peri-)anal fistulae are treated primarily with infliximab. Corticosteroids and aminosalicylates should be used with caution. In contrast, children and adolescents with ulcerative colitis are treated with either aminosalicylates or prednisolone to induce a remission. As a rule, maintenance pharmacotherapy with thiopurines in Crohn's disease and severe ulcerative colitis, or with aminosalicylates in mild to moderate ulcerative colitis, is indicated for several years, at least until the end of puberty. Patients with refractory disease courses are treated with methylprednisolone, anti-TNF-α-antibodies, and/or calcineurin inhibitors. The spectrum of surgical interventions is the same as for adults. Specific aspects of the treatment of children and adolescents with IBD include adverse drug effects, the areas of nutrition, growth, and development, and the structured transition to adult medicine. Conclusion: Children and adolescents with IBD or suspected IBD should be cared for by pediatric gastroenterologists in a center where such care is provided. Individualized treatment with multidisciplinary, family-oriented long-term care is particularly important. Drug trials in children and adolescents are needed so that the off-label use of drugs to patients in this age group can be reduced. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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