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Progressive Familial Intrahepatic Cholestasis: Is It Time to Transition to Genetic Cholestasis?
Squires, Robert H.?; Monga, Satdarshan Pal†
doi : 10.1097/MPG.0000000000003111
Journal of Pediatric Gastroenterology and Nutrition: May 2021 - Volume 72 - Issue 5 - p 641-643
Donor-Specific and Auto-Antibodies in Pediatric Liver Transplant: When Are They Important? What Do They Mean?
Smith, Kathryn?; Perito, Emily R.?,†
doi : 10.1097/MPG.0000000000003093
Journal of Pediatric Gastroenterology and Nutrition: May 2021 - Volume 72 - Issue 5 - p 643-644
Drugs in Focus: Proton Pump Inhibitors
Orel, Rok?; Benninga, Marc A.†; Broekaert, Ilse J.‡; Gottrand, Frederic§; Papadopoulou, Alexandra||; Ribes-Koninckx, Carmen¶; Thomson, Mike#; Wilschanski, Michael??; Thapar, Nikhil††,‡‡,§§
doi : 10.1097/MPG.0000000000003063
Journal of Pediatric Gastroenterology and Nutrition: May 2021 - Volume 72 - Issue 5 - p 645-653
Proton pump inhibitors (PPIs) are amongst the most commonly prescribed drugs in infants and children with the last decades witnessing a dramatic rise in their utilization. Although PPIs are clearly effective when used appropriately and have been regarded as safe drugs, there is growing evidence regarding their potential adverse effects. Although, largely based on adult data it is clear that many of these are also relevant to pediatrics. PPI use potentially affects gastrointestinal microbiota composition and function, decreases defence against pathogens resulting in increased risk for infections, interferes with absorption of minerals and vitamins leading to specific deficiencies and increased risk for bone fractures as well as interferes with protein digestion resulting in increased risk of sensitization to allergens and development of allergic diseases and eosinophilic esophagitis. An association with gastric, liver and pancreatic cancer has also been inferred from adult data but is tenuous and causation is not proven. Overall, evidence for these adverse events is patchy and not always compelling. Overall, the use of PPIs, for selected indications with a good evidence base, has significant potential benefit but carries more caution in infants and children. Pediatricians should be aware of the concerns regarding the potential adverse events associated with their use.
Use of a Comprehensive 66-Gene Cholestasis Sequencing Panel in 2171 Cholestatic Infants, Children, and Young Adults
Karpen, Saul J.?; Kamath, Binita M.†; Alexander, John J.‡,§; Ichetovkin, Ilia||; Rosenthal, Philip¶; Sokol, Ronald J.#; Dunn, Shelley||; Thompson, Richard J.??; Heubi, James E.††
doi : 10.1097/MPG.0000000000003094
Journal of Pediatric Gastroenterology and Nutrition: May 2021 - Volume 72 - Issue 5 - p 654-660
Cholestasis is caused by a wide variety of etiologies, often genetic in origin. Broad overlap in clinical presentations, particularly in newborns, renders prioritizing diagnostic investigations challenging. In this setting, a timely, comprehensive assessment using a multigene panel by a clinical diagnostic laboratory would likely prove useful. We summarize initial findings from a testing program designed to discover genetic causes of cholestasis.
Autoantibodies and Donor-specific Antibodies are Associated With Graft Dysfunction in Pediatric Liver Transplantation
Saelens, Emma Monique?; Van Biervliet, Stephanie?,†; Vande Velde, Saskia?,†; Van Winckel, Myriam?,†; Rogiers, Xavier?,‡; Vanlander, Aude‡; Daniëls, Liesbeth§; Bonroy, Carolien||,¶; De Bruyne, Ruth M.L.?,†
doi : 10.1097/MPG.0000000000002913
Journal of Pediatric Gastroenterology and Nutrition: May 2021 - Volume 72 - Issue 5 - p 661-666
Autoantibodies (AAb) and donor-specific HLA antibodies (DSA) are frequently present in pediatric liver transplant (LT) recipients. Their clinical significance remains incompletely understood. We aimed to investigate the prevalence of serum AAb and DSA in pediatric LT recipients and its correlation with patient characteristics and histological and biochemical parameters.
Dubin-Johnson Syndrome as Differential Diagnosis for Neonatal Cholestasis
Junge, Norman?; Goldschmidt, Imeke?; Wiegandt, Jessica?; Leiskau, Christoph?; Mutschler, Frauke?; Laue, Tobias?; Ohlendorf, Johanna?; Stalke, Amelie?,†; Hartleben, Bj?rn‡; Stindt, Jan§; Keitel, Verena§; Baumann, Ulrich?; Pfister, Eva-Doreen?
doi : 10.1097/MPG.0000000000003061
Journal of Pediatric Gastroenterology and Nutrition: May 2021 - Volume 72 - Issue 5 - p e105-e111
Dubin-Johnson syndrome (DJS) is an autosomal recessive disorder in which multidrug-resistance-associated protein 2 (MRP2) deficiency causes an excretion disorder of conjugated bilirubin from hepatocytes into bile canaliculi. Its clinical presentation as neonatal cholestasis (NC) is rare but represents an important differential diagnosis. We aimed to define DJS-specific characteristics in NC, in particular in contrast to biliary atresia (BA) patients, and to highlight diagnostic tools that can help to avoid invasive diagnostic tests.
Cholestasis Due to USP53 Deficiency
Bull, Laura N.?; Ellmers, Rebecca†; Foskett, Pierre†; Strautnieks, Sandra†; Sambrotta, Melissa‡; Czubkowski, Piotr§; Jankowska, Irena§; Wagner, Bart||; Deheragoda, Maesha†; Thompson, Richard J.†,‡
doi : 10.1097/MPG.0000000000002926
Journal of Pediatric Gastroenterology and Nutrition: May 2021 - Volume 72 - Issue 5 - p 667-673
Although a number of genetic forms of cholestasis have been identified, the genetic etiology of disease remains unidentified in a subset of cholestasis patients.
The Value of Obtaining Colonic Mucosal Biopsies of Grossly Normal Tissue in Pediatric Patients
Glass, Joshua?; Alcal?, Héctor E.†; Tobin, Michelle?,‡
doi : 10.1097/MPG.0000000000003038
Journal of Pediatric Gastroenterology and Nutrition: May 2021 - Volume 72 - Issue 5 - p 677-682
Current practice during pediatric colonoscopy is to obtain random colonic biopsies, even from normal appearing tissue. The majority of literature published on colonic biopsy practice analyzes adults; however, limited data examines the pediatric population. The lack of standardization regarding tissue sampling during pediatric colonoscopy reinforces the necessity to study this question objectively. The aim of the present study was to assess the value of obtaining mucosal biopsies from grossly normal colonic tissue.
Utilisation and Safety of Polyethylene Glycol 3350 With Electrolytes in Children Under 2 Years
Roy, Debabrata?,†; Akriche, Fatma‡; Amlani, Bharat§; Shakir, Saad?,†
doi : 10.1097/MPG.0000000000003074
Journal of Pediatric Gastroenterology and Nutrition: May 2021 - Volume 72 - Issue 5 - p 683-689
In the UK, Movicol paediatric plain (polyethylene glycol 3350 with electrolytes [PEG 3350+E], Norgine, UK), is licensed for chronic constipation in children 2 –11 years of age and faecal impaction (FI) from 5 years. This study aimed to investigate usage and characterise the risk profile in children under 2 years of age using PEG 3350+E in the UK.
Association Between Celiac Disease and Autism Spectrum Disorder: A Systematic Review
Quan, Joshua?,†; Panaccione, Nicola?; Jeong, Jocelyn†,‡; Underwood, Fox E.?; Coward, Stephanie†; Windsor, Joseph W.?,†; Ronksley, Paul E.†; Gidrewicz, Dominica‡; deBruyn, Jennifer†,‡; Turner, Justine M.§; Lebwohl, Benjamin||,¶; Kaplan, Gilaad G.?,†; King, James A.†,#,??
doi : 10.1097/MPG.0000000000003051
Journal of Pediatric Gastroenterology and Nutrition: May 2021 - Volume 72 - Issue 5 - p 704-711
The aim of the study was to perform a systematic review assessing the research investigating the association between celiac disease (CD) and autism spectrum disorder (ASD).
Diagnostic Value of Persistently Low Positive TGA-IgA Titers in Symptomatic Children With Suspected Celiac Disease
Trovato, Chiara Marja?; Montuori, Monica?; Morelli, Annalisa?; Alunni Fegatelli, Danilo†; Vestri, Annarita†; Giordano, Carla‡; Cucchiara, Salvatore?; Caio, Giacomo§; Oliva, Salvatore?
doi : 10.1097/MPG.0000000000003047
Journal of Pediatric Gastroenterology and Nutrition: May 2021 - Volume 72 - Issue 5 - p 712-717
While the algorithm to diagnose celiac disease (CD) in children with elevated anti-transglutaminase IgA (TGA-IgA) titers (>10 times upper limit of normal, ULN) is well defined, the management of children with low TGA-IgA values represents a clinical challenge. We aimed to identify the diagnostic value of persistently low positive TGA-IgA titers in predicting CD in children.
Deamidated Gliadin Antibodies: Do They Add to Tissue Transglutaminase-IgA Assay in Screening for Celiac Disease?
Abdulrahim, Ashraf?; Fagih, Mosa†,‡; Troncone, Riccardo§; Bashir, Muhammed Salman||; Asery, Ali?; Alruwaithi, Muhanad?; Al-Jurayyan, Abdullah N.||; Al-Alallah, Ibrahim||; Al-Hussaini, Abdulrahman?,¶,#
doi : 10.1097/MPG.0000000000003022
Journal of Pediatric Gastroenterology and Nutrition: May 2021 - Volume 72 - Issue 5 - p e112-e118
Use of deamidated gliadin peptide (DGP) test kits as adjunctive to tissue-transglutaminase-IgA (TTG-IgA) for the diagnosis of celiac disease (CD) has been a controversial issue. The objectives of our study were to evaluate the diagnostic performance of DGP antibodies compared with TTG-IgA and to evaluate the correlation between DGP-antibody titers and degree of enteropathy.
Long-term Follow-up for Missed Cases of Eosinophilic Esophagitis in Children With Previous Foreign Body in the Esophagus
Thulin, Helena?,†; Nilsson, Caroline?,†; Svensson, Jan F.‡,§; Olén, Ola?,†,||; Altman, Maria||
doi : 10.1097/MPG.0000000000003045
Journal of Pediatric Gastroenterology and Nutrition: May 2021 - Volume 72 - Issue 5 - p e119-e124
A foreign body impacted in the esophagus could be a sign of eosinophilic esophagitis (EoE). Our aim was to investigate if children previously diagnosed with a foreign body in the esophagus had a missed diagnosis of EoE.
Integration of eHealth Into Pediatric Inflammatory Bowel Disease Care is Safe: 3 Years of Follow-up of Daily Care
Carlsen, Katrine?,†; Frederiksen, Nicoline Willum?; Wewer, Vibeke?
doi : 10.1097/MPG.0000000000003053
Journal of Pediatric Gastroenterology and Nutrition: May 2021 - Volume 72 - Issue 5 - p 723-727
The aim of the study was to evaluate integration of an eHealth solution, www.young.constant-care.com, into daily care (I-eHealth).
Progressive Familial Intrahepatic Cholestasis Associated With USP53 Gene Mutation in a Brazilian Child
Porta, Gilda?; Rigo, Paula S.M.?; Porta, Adriana?; Pugliese, Renata P.S.?; Danesi, Vera L.B.?; Oliveira, Eliene?; Borges, Cristian C.V.?; Ribeiro, Cristiane†; Miura, Irene K.?
doi : 10.1097/MPG.0000000000003110
Journal of Pediatric Gastroenterology and Nutrition: May 2021 - Volume 72 - Issue 5 - p 674-676
A case of low-?-glutamyltranspetidase cholestasis associated with ubiquitin-specific peptidase 53 (USP53) gene mutation in a Brazilian child is described. Transient jaundice and hypocholia started at the age of 10 days. Liver enzymes, total bilirubin, and total bile acids were elevated at presentation. During follow-up, he developed cholelithiasis treated with cholecystectomy, and an intracranial hemorrhage resolved with full recovery. At last, evaluation at the age of 18 months, he was not jaundiced and had normal liver tests, but experienced from moderate pruritus despite treatment with rifampicin and ursodeoxycholic acid. A genetic study revealed novel homozygous mutations c.1687_1688delinsC p.Ser563Profs?25 in the USP53 gene. His parents carried the same heterozygous mutation in the USP53 gene.
Type 2 Immunity and Age Modify Gene Expression of Coronavirus-induced Disease 2019 Receptors in Eosinophilic Gastrointestinal Disorders
Chiang, Austin W.T.?,†; Duong, Loan D.‡; Shoda, Tetsuo§; Nhu, Quan M.?,||; Ruffner, Melanie#; Hara, Takeo¶; Aaron, Bailey¶; Joplin, Erik‡; Manresa, Mario C.?; Abonia, J. Pablo§; Dellon, Evan S#; Hirano, Ikuo??; Gonsalves, Nirmala??; Gupta, Sandeep K.††; Furuta, Glenn T.‡‡; Rothenberg, Marc E.§; Lewis, Nathan E.‡; Muir, Amanda B.¶; Aceves, Seema S.?,§§; the CEGIR Investigator Group
doi : 10.1097/MPG.0000000000003032
Journal of Pediatric Gastroenterology and Nutrition: May 2021 - Volume 72 - Issue 5 - p 718-722
Infection with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) can lead to coronavirus-induced disease 2019 (COVID-19). The gastrointestinal (GI) tract is now an appreciated portal of infection. SARS-CoV-2 enters host cells via angiotensin-converting enzyme-2 (ACE2) and the serine protease TMPRSS2. Eosinophilic gastrointestinal disorders (EGIDs) are inflammatory conditions caused by chronic type 2 (T2) inflammation. the effects of the T2 atopic inflammatory milieu on SARS-COV-2 viral entry gene expression in the GI tract is poorly understood. We analyzed tissue ACE2 and TMPRSS2 gene expression in pediatric eosinophilic esophagitis (EoE), eosinophilic gastritis (EG), and in normal adult esophagi using publicly available RNA-sequencing datasets. Similar to findings evaluating the airway, there was no difference in tissue ACE2/TMPRSS2 expression in EoE or EG when compared with control non-EoE/EG esophagus/stomach. ACE2 gene expression was significantly lower in esophagi from children with or without EoE and from adults with EoE as compared with normal adult esophagi. Type 2 immunity and pediatric age could be protective for infection by SARS-CoV-2 in the gastrointestinal tract because of decreased expression of ACE2.
Esophageal Squamous Papilloma in Children: A Single-center Case Series
Tou, Andrea M.; Al-Nimr, Amer O.
doi : 10.1097/MPG.0000000000003066
Journal of Pediatric Gastroenterology and Nutrition: May 2021 - Volume 72 - Issue 5 - p 690-692
Esophageal squamous papilloma (ESP) is a rare epithelial lesion most commonly seen in adults, with an unclear etiology and limited pediatric data available. The aim of this study was to provide an estimated prevalence of this lesion in our pediatric population, as well as to identify any demographic, clinical, or pathologic associations—including human papilloma virus (HPV) infection, which has been linked with ESP in adult literature.
Alternative Diagnoses in Pediatric Fecal Microbiota Transplant Referral Patients
Ruan, Wenly?,†; Kellermayer, Richard?,†,‡
doi : 10.1097/MPG.0000000000003060
Journal of Pediatric Gastroenterology and Nutrition: May 2021 - Volume 72 - Issue 5 - p 693-696
The incidence of Clostridioides difficile infection (CDI) has been increasing in the United States. About 10–20% recur after initial treatment, with increasing recurrence following subsequent treatment courses. This sequence can lead to recurrent CDI (rCDI), refractory to conventional therapeutics resulting in the most common indication for fecal microbiota transplantation (FMT). FMT is the most effective microbial therapeutic to date and can cure rCDI in 80–90% of cases. There is growing concern, however, for pathogen transmission through FMT, underscoring the importance of careful recipient selection. In adults referred for FMT with a tentative diagnosis of rCDI, alternative diagnoses were recognized in 25% of patients, but such observation in children is lacking. In this single-center retrospective study, alternative diagnoses (eg, constipation/overflow diarrhea, inflammatory bowel disease) were found in 13 (22.4%) of 58 children who were referred for FMT evaluation for rCDI. Of the patients who were diagnosed with rCDI, 16 (27.6%) did not require FMT.
New Guidance on Cytochrome P450 2C19 Phenotype-based Use of Proton Pump Inhibitors
Sabet, Samie; McGhee, Jessica E.
doi : 10.1097/MPG.0000000000003082
Journal of Pediatric Gastroenterology and Nutrition: May 2021 - Volume 72 - Issue 5 - p 697-699
Since the approval of the first proton pump inhibitor (PPI) in 1989, our knowledge regarding this class of medications has further developed. An increasing amount of data now supports the association between cytochrome P450 2C19 (CYP2C19) phenotype and PPI safety and efficacy. This includes pediatric studies, such as those published here and in other pediatric journals within the past year. Moreover, the most recent pediatric Helicobacter pylori guidelines stated that using the PPIs that are less dependent on CYP2C19 for inactivation may be preferred for H pylori eradication among populations that are more likely to have rapid clearance of CYP2C19-metabolized PPIs. Conversely, pantoprazole package insert recommends a dose reduction in known pediatric CYP2C19 poor metabolizers (PMs), citing a 6-fold increase in serum concentrations compared with normal metabolizers (NMs). The purpose of this communication is to introduce a recently published Clinical Pharmacogenetics Implementation Consortium (CPIC) guideline for CYP2C19 and PPI dosing.
The 21st Century CURES Act in Pediatric Gastroenterology: Problems, Solutions, and Preliminary Guidance
Lee, Jennifer A.?,†,‡; Miller, Steven D.§; Mezoff, Ethan A.?,‡; Screws, Jeremy||; Sauer, Cary¶; Huang, Jeannie S.#,??
doi : 10.1097/MPG.0000000000003117
Journal of Pediatric Gastroenterology and Nutrition: May 2021 - Volume 72 - Issue 5 - p 700-703
The information blocking (IB) prohibition component of the 21st Century CURES Act (21CCA) comes into effect April 5, 2021, which gives patients and their families near-instant access to almost all clinical notes, lab results, and health data. Exceptions to IB prohibition include risk of harm and patient privacy, but violations can be punished by a fine of up to $1,000,000.00. A committee of pediatric gastroenterologists reviewed the 21CCA regulation and compared local practice policies. Pediatric practitioners need to understand how age will affect local information release policies and to know which note types are released, paying special consideration to trainee notes and confidential information. Extraneous detail should be removed from notes, emotional labeling be avoided, and objective statements be made when referring to the care of other providers. Awareness of the 21CCA provides pediatric gastroenterologists with the opportunity to adapt their medical documentation practices to accommodate the new law.
Mucosal and Histologic Healing in Children With Inflammatory Bowel Disease Treated With Antitumor Necrosis Factor-Alpha
Scarallo, Luca?; Alvisi, Patrizia†; Bolasco, Giulia†; Di Toma, Michele?; Lanari, Marcello‡; Cangiari, Alice†; Paci, Monica?; Naldini, Sara?; Renzo, Sara?; Barp, Jacopo?; De Masi, Salvatore§; Lionetti, Paolo||
doi : 10.1097/MPG.0000000000003043
Journal of Pediatric Gastroenterology and Nutrition: May 2021 - Volume 72 - Issue 5 - p 728-735
Mucosal healing (MH) and histological healing (HH) have been recently proposed as a novel treatment target for inflammatory bowel disease (IBD). The aim of the present study was to evaluate real-life achievement of such outcomes in a cohort of pediatric patients with IBD treated with anti-TNF-alpha (ATA) agents.
Safety of Biological Therapy in Children With Inflammatory Bowel Disease
D’Arcangelo, Giulia; Distante, Manuela; Raso, Tonia; Rossetti, Danilo; Catassi, Giulia; Aloi, Marina
doi : 10.1097/MPG.0000000000003044
Journal of Pediatric Gastroenterology and Nutrition: May 2021 - Volume 72 - Issue 5 - p 736-741
Retrospective, observational, single-center, cohort study investigating the safety profile of biological therapy in children with inflammatory bowel disease (IBD).
The Impact of Vitamin D on Response to Anti-tumor Necrosis Factor-? Therapy in Children With Inflammatory Bowel Disease
Hizarcioglu-Gulsen, Hayriye?,†; Kaplan, Jess L.?; Moran, Christopher J.?; Israel, Esther J.?; Lee, Hang‡; Winter, Harland?
doi : 10.1097/MPG.0000000000003064
Journal of Pediatric Gastroenterology and Nutrition: May 2021 - Volume 72 - Issue 5 - p e125-e131
Experimental studies have shown that vitamin D has an immunomodulatory effect on the innate and adaptive immune systems. Associations between vitamin D deficiency and development or progression of inflammatory bowel diseases (IBDs) are reported, but a cause-and-effect relationship between pretreatment 25 hydroxyvitamin D [25(OH)D] levels and response to anti-tumor necrosis factor-? (anti-TNF) therapy is not established.
Venous Thromboembolism in Pediatric Inflammatory Bowel Disease: A Case-Control Study
Mitchel, Elana B.?; Rosenbaum, Sara?; Gaeta, Christopher?; Huang, Jing†; Raffini, Leslie J.‡; Baldassano, Robert N.?; Denburg, Michelle R.§; Albenberg, Lindsey?
doi : 10.1097/MPG.0000000000003078
Journal of Pediatric Gastroenterology and Nutrition: May 2021 - Volume 72 - Issue 5 - p 742-747
Inflammatory bowel disease (IBD) is associated with increased risk of venous thromboembolism (VTE). Despite this recognized risk, there are limited data and no anticoagulation guidelines for hospitalized pediatric IBD patients. The objectives of this study were to characterize pediatric IBD patients with VTE and determine risk factors.
Comparison of the Effect of Holder Pasteurization and High-Pressure Processing on Human Milk Bacterial Load and Bioactive Factors Preservation
Dussault, Nathalie; Cayer, Marie-Pierre; Landry, Patricia; de Grandmont, Marie-Joëlle; Cloutier, Marc; Thibault, Louis; Girard, Mélissa
doi : 10.1097/MPG.0000000000003065
Journal of Pediatric Gastroenterology and Nutrition: May 2021 - Volume 72 - Issue 5 - p 756-762
This project aims at comparing the impact of Holder pasteurization (HoP) and high-pressure processing (HPP) on bacterial load and retention of immunological components in human milk.
Enteral Feeding and Necrotizing Enterocolitis: Does Time of First Feeds and Rate of Advancement Matter?
Masoli, Daniela?; Dominguez, Angelica†; Tapia, José L.?; Uauy, Ricardo?; Fabres, Jorge?; for the NEOCOSUR Collaborative Network
doi : 10.1097/MPG.0000000000003069
Journal of Pediatric Gastroenterology and Nutrition: May 2021 - Volume 72 - Issue 5 - p 763-768
The aim of the study was to determine if time to initial enteral feeding (EF) and rate of advancement are associated with necrotizing enterocolitis (NEC) or death.
Intestinal Microbiome in Preterm Infants Influenced by Enteral Iron Dosing
Ho, Thao?,†; Sarkar, Anujit†; Szalacha, Laura†; Groer, Maureen W.†
doi : 10.1097/MPG.0000000000003033
Journal of Pediatric Gastroenterology and Nutrition: May 2021 - Volume 72 - Issue 5 - p e132-e138
The aim of the study was to compare the intestinal microbiome in very low birth weight (VLBW) infants who received different enteral iron supplementation (EIS) doses.
Health and Financial Burdens Associated With Venous Thrombosis in Hospitalized Children With Inflammatory Bowel Disease
Chien, Kimberley A.?; Cooley, Victoria†; Prishtina, Fisnik‡; Grinspan, Zachary M.?,†; Gerber, Linda M.†; Kucine, Nicole?
doi : 10.1097/MPG.0000000000003052
Journal of Pediatric Gastroenterology and Nutrition: May 2021 - Volume 72 - Issue 5 - p 748-751
Venous thromboembolism (VTE) is a known complication in children with inflammatory bowel disease (IBD). Despite awareness of the increased thrombosis risk in this population, prophylaxis is not standardly used and there is limited published guidance for thrombosis prevention. To better appreciate the impact of thrombosis in this population, we compared children with IBD who did or did not have a VTE, using the Pediatric Health Information System inpatient database from 2009 to 2017. In hospitalized children with IBD, VTE was associated with longer median hospital stays (11 vs 5 days), need for intensive care unit admission (30.2% vs 4.8%), higher median adjusted costs ($32.8k vs $12.3k) and hospital charges ($96.6k vs $36k), and in-hospital death (1.5% vs 0.2%) (P < 0.001 in all comparisons). These findings highlight the need to determine and implement appropriate strategies to reduce VTE rates in children with IBD, given its association with high morbidity, mortality, and cost.
Recommendations for Transgender and Gender Nonconforming Adolescents and Young Adults With Inflammatory Bowel Disease
Schenker, Rachel B.?; Wilson, Erin?; Russell, Meredith†; Cooke, Laura C.‡; Heyman, Melvin B.‡; Verstraete, Sofia G.‡
doi : 10.1097/MPG.0000000000003027
Journal of Pediatric Gastroenterology and Nutrition: May 2021 - Volume 72 - Issue 5 - p 752-755
Transgender and gender nonconforming (TGNC) individuals have a different gender identity than the sex they were assigned at birth. Despite an increase in provider awareness of TGNC health over the past decade, no original research or societal guidelines exist on TGNC patients with inflammatory bowel disease (IBD). We review TGNC IBD cases in the University of California, San Francisco (UCSF) Pediatric IBD Program and in the literature. We then provide some recommendations for the provision of high-quality care to the TGNC IBD population, divided into 3 categories: medications, anatomy, and mental health.
Role of Dietary Factors, Food Habits, and Lifestyle in Childhood Obesity Development: A Position Paper From the European Society for Paediatric Gastroenterology, Hepatology and Nutrition Committee on Nutrition
Verduci, Elvira?,†; Bronsky, Jiri‡; Embleton, Nicholas§; Gerasimidis, Konstantinos||; Indrio, Flavia¶; K?glmeier, Jutta#; de Koning, Barbara??; Lapillonne, Alexandre††,‡‡; Moltu, Sissel Jennifer§§; Norsa, Lorenzo||||; Domell?f, Magnus¶¶; ESPGHAN Committee on Nutrition
doi : 10.1097/MPG.0000000000003075
Journal of Pediatric Gastroenterology and Nutrition: May 2021 - Volume 72 - Issue 5 - p 769-783
Childhood obesity has high societal and economic impact but current treatment approaches are sub-optimal. In the last decade, important studies have been conducted aiming to identify strategies to prevent obesity during critical periods of life. Updated recommendations for childhood obesity prevention are needed. We present data from systematic reviews and meta- analysis, randomised controlled trials (RCTs) and large observational studies, published from 2011 onwards that consider the possible role of the following factors in obesity development: breast-feeding; macronutrient composition and method of complementary feeding; parenting style; dietary patterns; sugar-sweetened beverage consumption; eating behaviour (eg, skipping breakfast, family dinners. etc); meal frequency and composition (fast foods, snacking), portion size; dietary modulators of gut microbiota (including pre-, pro-, and synbiotics); physical activity and sedentary behaviour. We used the Medline database and the Cochrane Library to search for relevant publications. Important research gaps were also identified. This position paper provides recommendations on dietary factors, food habits, and lifestyle to prevent childhood obesity development, based on the available literature and expert opinion. Clinical research and high-quality trials are urgently needed to resolve numerous areas of uncertainty.
Diet Advancement Based on Repeat Upper Gastrointestinal Endoscopies After Removal of an Esophageal Button Battery
Choi, Sujin?; Choe, Byung-Ho?; Lee, So Mi†; Kang, Ben?
doi : 10.1097/MPG.0000000000003086
Journal of Pediatric Gastroenterology and Nutrition: May 2021 - Volume 72 - Issue 5 - p e139
The First Documented Case of Pediatric Colonic Pseudolipomatosis in a 15-Year-old Girl
Shavrov, Anton A. Jr; Tertychnyy, Alexander S.; Ibragimov, Sultan I.
doi : 10.1097/MPG.0000000000003062
Journal of Pediatric Gastroenterology and Nutrition: May 2021 - Volume 72 - Issue 5 - p e139
