Prokinetics in Childhood Gastroesophageal Reflux Disease: Are They Indicated?
No abstract available (Source: Journal of Pediatric Gastroenterology and Nutrition)
Source: Journal of Pediatric Gastroenterology and Nutrition - June 1, 2021 Category: Gastroenterology Tags: Letters to the Editor Source Type: research

Double Superior Vena Cava in Alagille Syndrome: Left is Not The Right Choice
No abstract available (Source: Journal of Pediatric Gastroenterology and Nutrition)
Source: Journal of Pediatric Gastroenterology and Nutrition - June 1, 2021 Category: Gastroenterology Tags: Image of the Month Source Type: research

Glycogenic Acanthosis in a Child Diagnosed With Eosinophilic Esophagitis
No abstract available (Source: Journal of Pediatric Gastroenterology and Nutrition)
Source: Journal of Pediatric Gastroenterology and Nutrition - June 1, 2021 Category: Gastroenterology Tags: Image of the Month Source Type: research

Reference Values Matter: Fewer Patients With Malnutrition Using American Compared to More Recent German Growth Charts
Reference values are important for patient care as well as for comparisons between different centers or countries. We investigated two anthropometric reference datasets, the US Centers for Disease Control (CDC) growth charts and the German Health Interview and Examination Survey for Children and Adolescents Study (KiGGS) percentiles, which were established in Germany between 2003 and 2006. A smaller proportion of children with cystic fibrosis had decreased z scores (Source: Journal of Pediatric Gastroenterology and Nutrition)
Source: Journal of Pediatric Gastroenterology and Nutrition - June 1, 2021 Category: Gastroenterology Tags: Short Communication: Nutrition Source Type: research

Long-Term Results of Laparoscopic Adjustable Gastric Banding in French adolescents: The Utmost Importance of Follow-Up
Objectives: To investigate the long-term follow-up (FU) and effectivity of laparoscopic adjustable gastric banding (LAGB) in a French adolescent cohort. Methods: We retrospectively analyzed the results of LAGB at our institution. We collected information on FU, adjustable gastric banding (AGB) status, weight-related parameters, and comorbidity at multiple timepoints. Results: Fifty-six patients (77% female) with a mean age of 16.5 years and a mean body mass index (BMI) of 45 kg/m2 underwent LAGB over a period of 12 years. The mean postpediatric FU was 23 months. FU decreased progressively from 96%...
Source: Journal of Pediatric Gastroenterology and Nutrition - June 1, 2021 Category: Gastroenterology Tags: Original Articles: Nutrition Source Type: research

Neurotrophic Factors in Human Milk in Early Lactation and the Effect of Holder and Microwave Pasteurization on Their Concentrations
The objective of this study was to determine the level of brain-derived neurotrophic factor (BDNF) and glial cell line-derived neurotrophic factor (GDNF) in human milk in the first 2 weeks of breast-feeding and compare the effects of Holder pasteurization (HoP, 62.5 °C, 30 minutes) and microwave pasteurization (MP) at constant temperature (62.5 °C) on the concentraion of both neurotrophic factors (NFs). Methods: Concentration of NFs in human milk was determined using a commercially available ELISA assay. Results: The average concentration of BDNF and GDNF in milk was 11 ± 6 ng/mL an...
Source: Journal of Pediatric Gastroenterology and Nutrition - June 1, 2021 Category: Gastroenterology Tags: Original Articles: Nutrition Source Type: research

Nutritional Therapy in Children With Spinal Muscular Atrophy in the Era of Nusinersen
Objectives: Spinal muscular atrophy (SMA) is a genetic motor neuron disorder characterized by progressive muscle atrophy. Our aims were to evaluate the impact of nutritional intervention and nusinersen therapy on the nutritional status of SMA patients. Study design: This prospective study included all children and young adults ( (Source: Journal of Pediatric Gastroenterology and Nutrition)
Source: Journal of Pediatric Gastroenterology and Nutrition - June 1, 2021 Category: Gastroenterology Tags: Original Articles: Nutrition Source Type: research

Age-Dependent Trends in the Celiac Disease: A Tertiary Center Experience
Objectives: Celiac disease (CD) is a common intestinal autoimmune disorder with diverse presenting features. We aimed to determine age-dependent patterns in CD presentation, diagnosis and management at a large tertiary referral center. Methods: A retrospective review of electronic medical records of pediatric patients diagnosed with CD between January 1999 and December 2018 at Schneider Children's Medical Center of Israel. We compared demographics, clinical and laboratory parameters between four age groups at CD presentation. Results: A cohort of 932 children was divided into four groups by age (in years)...
Source: Journal of Pediatric Gastroenterology and Nutrition - June 1, 2021 Category: Gastroenterology Tags: Original Articles: Gastroenterology: Celiac Disease Source Type: research

Low-Risk Human Leukocyte Antigen Genes and Mild Villous Atrophy Typify Celiac Disease With Immunoglobulin A Deficiency
Objectives: We aimed to establish if in celiac disease (CD) with immunoglobulin A deficiency (IgAD) duodenal histopathology is influenced by human leukocyte antigen (HLA)-DQB1∗02 alleles dosage. Clinical differences between patients with CD and patients with CD and IgAD (CD-IgAD) were also evaluated. Methods: Five hundred and sixteen CD and 16 patients with CD-IgAD, enrolled over the time of 8 years, took part in this study. The severity of duodenal histopathology and frequency of CD at-risk HLA class II genes were compared in patients with CD versus patients with CD-IgAD. HLA class II genotypes were su...
Source: Journal of Pediatric Gastroenterology and Nutrition - June 1, 2021 Category: Gastroenterology Tags: Original Articles: Gastroenterology: Celiac Disease Source Type: research

Celiac Disease Management in the United Kingdom Specialist Pediatric Gastroenterology Centers—A Service Survey
Conclusions: There was excellent uptake of ESPGHAN guidelines (2012) in the UK and adherence to guidelines is generally good. Despite published evidence and pragmatic advice from the British Society of Paediatric Gastroenterology Hepatology and Nutrition and National Institute for Health and Care Excellence, significant differences remain in diagnostic and ongoing management practice and are opportunities for research and directive evidence-based follow-up guidance. (Source: Journal of Pediatric Gastroenterology and Nutrition)
Source: Journal of Pediatric Gastroenterology and Nutrition - June 1, 2021 Category: Gastroenterology Tags: Original Articles: Gastroenterology: Celiac Disease Source Type: research

Sarcopenia is a Predictor for Adverse Clinical Outcome in Pediatric Inflammatory Bowel Disease
Objectives: Inflammatory bowel disease (IBD) has a high impact on nutritional status. Sarcopenia is related to higher risk of surgery and rescue therapy in adults with IBD; however, comparable data in pediatric populations are scarce. We evaluated muscle mass as a predictor of disease outcome in pediatric IBD. Methods: All pediatric IBD patients who underwent magnetic resonance enterography (MRE) during 2008 to 2019 were included. Muscle mass was assessed by measuring the area of the psoas muscle at the upper level of L3 on MRE. The psoas area divided by the body surface area (BSA) yielded the psoas index. Clini...
Source: Journal of Pediatric Gastroenterology and Nutrition - June 1, 2021 Category: Gastroenterology Tags: Original Articles: Gastroenterology: Inflammatory Bowel Disease Source Type: research

The Effect of Nutritional Therapy on Bone Mineral Density and Bone Metabolism in Pediatric Crohn Disease
Objectives: Both the inflammatory burden of Crohn disease (CD) and corticosteroids have a negative effect on bone density. Exclusive enteral nutrition (EEN) avoids corticosteroids and promotes endoscopic healing. We aimed to explore the effect of nutritional therapy on bone health in pediatric CD. Methods: This was a planned sub-study of a clinical trial enrolling children with new-onset mild-moderate CD. Children were randomized to either 6 weeks EEN followed by 6 weeks 25% partial enteral nutrition (PEN) or 6 weeks of 50% PEN with a CD exclusion diet followed by 6 weeks of 25% PEN with exclusion diet. ...
Source: Journal of Pediatric Gastroenterology and Nutrition - June 1, 2021 Category: Gastroenterology Tags: Original Articles: Gastroenterology: Inflammatory Bowel Disease Source Type: research

Therapeutic Drug Monitoring of Adalimumab During Long-term Follow-up in Paediatric Patients With Crohn Disease
Conclusions: ADL TLs were significantly higher in paediatric patients with CD who achieved CR or MH. ADL treatment showed long-term stable efficacy and positive effects on growth indicators. (Source: Journal of Pediatric Gastroenterology and Nutrition)
Source: Journal of Pediatric Gastroenterology and Nutrition - June 1, 2021 Category: Gastroenterology Tags: Original Articles: Gastroenterology: Inflammatory Bowel Disease Source Type: research

Influence of Family History on Children With Irritable Bowel Syndrome
The influence of family history on children with irritable bowel syndrome (IBS) is unknown. We conducted a retrospective study to compare the clinical profile and management differences between children with a family history of IBS (FH-IBS) versus without. A total of 251 children were included in the study, 75 (30%) had FH-IBS and 176 (70%) did not. No significant differences were observed between the 2 groups in sex composition, age at initial visit, age of IBS diagnosis, dietary modifications, supplements, laxatives, antispasmodics, antidiarrheals, and cyproheptadine use. Children with FH-IBS were, however, more like to ...
Source: Journal of Pediatric Gastroenterology and Nutrition - June 1, 2021 Category: Gastroenterology Tags: Short Communication: Gastroenterology Source Type: research

Markers of Bile Acid Metabolism in Pediatric Diarrhea Predominant Irritable Bowel Syndrome and Healthy Controls
Objectives: Excessive fecal bile acids in adults have been associated with diarrhea-predominant irritable bowel syndrome (IBS-D), but their role in pediatric IBS-D is unknown. Serum markers including 7α-hydroxy-4-cholesten-3-one (C4) and fibroblast growth factor-19 (FGF-19) were validated in adults to detect bile acid diarrhea (BAD) compared to 48-hour fecal bile acid collection (48FBA). Our aims were to assess fasting serum C4 and FGF–19 and 48FBA in a pediatric population, to compare measurements in IBS-D patients and healthy controls (HC), and to determine the prevalence of BAD among children with IBS-D....
Source: Journal of Pediatric Gastroenterology and Nutrition - June 1, 2021 Category: Gastroenterology Tags: Original Articles: Gastroenterology Source Type: research

Clinical and Esophagogastroduodenoscopy Findings in Pediatric Patients With Severe Obesity Evaluated Before Bariatric Surgery
Conclusions: Endoscopies performed before bariatric surgeries suggest a higher prevalence of clinically significant findings, many of which required treatment. These findings support incorporating an EGD into the preoperative evaluation of this patient population. (Source: Journal of Pediatric Gastroenterology and Nutrition)
Source: Journal of Pediatric Gastroenterology and Nutrition - June 1, 2021 Category: Gastroenterology Tags: Original Articles: Gastroenterology Source Type: research

Clinical Characterization of Pediatric Gastroparesis Using a Four-hour Gastric Emptying Scintigraphy Standard
Objectives: Four-hour gastric emptying scintigraphy (GES) is the recommended method to identify both adult and childhood gastroparesis (GP). Previous pediatric studies have, however, not used this standard. We sought to determine the characteristics and outcomes of children versus adolescents with GP using the 4-hour GES evaluation. Methods: We performed a retrospective chart review of pediatric patients diagnosed with GP by 4-hour GES (>10% retention at 4 hours). Demographics, body mass index, GP-related symptoms, comorbidities, etiologies, therapies (eg, medications), healthcare utilization, and response ...
Source: Journal of Pediatric Gastroenterology and Nutrition - June 1, 2021 Category: Gastroenterology Tags: Original Articles: Gastroenterology Source Type: research

Measuring Gastric pH in Tube-fed Children With Neurologic Impairments and Gastroesophageal Disease
Conclusions: The findings suggest that both point-of-care tests, the pH meter and pH paper, correlate well with the gold standard for testing pH with a laboratory pH meter, indicating usefulness in point-of-care testing for monitoring gastric pH in tube-fed children with neurologic impairments and GERD. (Source: Journal of Pediatric Gastroenterology and Nutrition)
Source: Journal of Pediatric Gastroenterology and Nutrition - June 1, 2021 Category: Gastroenterology Tags: Original Articles: Gastroenterology Source Type: research

Artificial Intelligence-based Analytics for Diagnosis of Small Bowel Enteropathies and Black Box Feature Detection
Conclusions: Our AI-based image analysis platform demonstrated high classification accuracy for small bowel enteropathies which was capable of identifying biologically relevant microscopic features and emulating human pathologist decision-making process. Grad-CAMs illuminated the otherwise “black box” of deep learning in medicine, allowing for increased physician confidence in adopting these new technologies in clinical practice. (Source: Journal of Pediatric Gastroenterology and Nutrition)
Source: Journal of Pediatric Gastroenterology and Nutrition - June 1, 2021 Category: Gastroenterology Tags: Original Articles: Gastroenterology Source Type: research

Genetic Enteropathies Linked to Epithelial Structural Abnormalities and Enteroendocrine Deficiency: A Systematic Review
Conclusions: This review presents data from 323 patients with congenital diarrhea linked to EPCAM TE, SPINT2 TE, TTC37 THE, SKIV2L THE, MYO5B MVID, STX3 MVID, NEUROG3 ED, and PCSK1 ED mutations. (Source: Journal of Pediatric Gastroenterology and Nutrition)
Source: Journal of Pediatric Gastroenterology and Nutrition - June 1, 2021 Category: Gastroenterology Tags: Original Articles: Gastroenterology Source Type: research

Long-term Morbidity of Choledochal Malformations in Children
Conclusions: Whilst cholangitis was the most common postoperative problem, individual patients experienced other more significant complications and one quarter of patients showed evidence of underlying liver dysfunction. (Source: Journal of Pediatric Gastroenterology and Nutrition)
Source: Journal of Pediatric Gastroenterology and Nutrition - June 1, 2021 Category: Gastroenterology Tags: Original Articles: Hepatology Source Type: research

Safety of High-Volume Plasmapheresis in Children With Acute Liver Failure
Conclusion: HVP with fresh frozen plasma is feasible and well tolerated in children with P-ALF. No serious adverse events and no procedure-related mortality were observed. (Source: Journal of Pediatric Gastroenterology and Nutrition)
Source: Journal of Pediatric Gastroenterology and Nutrition - June 1, 2021 Category: Gastroenterology Tags: Original Articles: Hepatology Source Type: research

Seroprevalence of Hepatitis C in Children Without Identifiable Risk-Factors: A Systematic Review and Meta-Analysis
Objectives: Hepatitis C virus (HCV) remains a major public health burden for>30 years since its discovery. It is estimated that>80 million people have been already infected. Direct-acting antiviral (DAA) treatment is now approved for young children over the age of 3 years. Treating children before the development of high-risk behaviors is optimal. Thus, assessing the current epidemiology of HCV in children becomes important and may promote awareness. Methods: Articles describing the prevalence of hepatitis C in children, were systematically reviewed. To assess HCV infection prevalence in the general po...
Source: Journal of Pediatric Gastroenterology and Nutrition - June 1, 2021 Category: Gastroenterology Tags: Original Articles: Hepatology Source Type: research

Severe Acute Respiratory Syndrome Coronavirus-2 Infection in Children With Liver Transplant and Native Liver Disease: An International Observational Registry Study
Objective: Increased mortality risk because of severe acute respiratory syndrome coronavirus-2 (SARS-CoV2) infection in adults with native liver disease (LD) and liver transplant (LT) is associated with advanced age and comorbid conditions. We aim to report outcomes for children with LD and LT enrolled in the NASPGHAN/SPLIT SARS-CoV2 registry. Methods: In this multicenter observational cohort study, we collected data from 91 patients (Source: Journal of Pediatric Gastroenterology and Nutrition)
Source: Journal of Pediatric Gastroenterology and Nutrition - June 1, 2021 Category: Gastroenterology Tags: Original Articles: Hepatology Source Type: research

Non-invasive Predictors of Esophageal Varices With a High Risk of Bleeding in Pediatric Cirrhotic Patients
Conclusions: The described predictors allow the correct identification of patients with HRV. The association of RS>−1.2 or APRi>1.4 has a good sensitivity to identify HRV and to prevent unnecessary endoscopy in about one-third of children with no HRV. (Source: Journal of Pediatric Gastroenterology and Nutrition)
Source: Journal of Pediatric Gastroenterology and Nutrition - June 1, 2021 Category: Gastroenterology Tags: Original Articles: Hepatology Source Type: research

Functional Fecal Incontinence in Children: Epidemiology, Pathophysiology, Evaluation, and Management
Functional fecal incontinence (FI) is a worldwide problem in children and comprises constipation-associated FI and nonretentive FI. Irrespective of pathophysiology, both disorders impact negatively on the psychological well-being and quality of life of affected children. A thorough clinical history and physical examination using the Rome IV criteria are usually sufficient to diagnose these conditions in most children. Evolving investigations such as high-resolution anorectal and colonic manometry have shed new light on the pathophysiology of functional FI. Although conventional interventions such as toilet training and lax...
Source: Journal of Pediatric Gastroenterology and Nutrition - June 1, 2021 Category: Gastroenterology Tags: Review Article Source Type: research

Current Evidence on the Clinical Relevance of Donor-specific Antibodies in Paediatric Liver Transplantation
The clinical impact of donor-specific antibodies (DSA) occurring before or after liver transplantation (LT) against donor-human leucocyte antigen (HLA) on graft outcome is still unclear. We aim to present the current consensus based on recent paediatric LT case series. Compared to kidney transplantation, the liver seems to be less susceptible to antibody-mediated graft damage, which is likely due to protective Kupffer cell activity. The incidence of DSA after liver transplantation is higher in children than in adults. DSA directed against HLA class II molecules, mainly DQ, occur more often. The presence of such anti-class ...
Source: Journal of Pediatric Gastroenterology and Nutrition - June 1, 2021 Category: Gastroenterology Tags: Topic of the Month Source Type: research

High-volume Plasmapheresis in Children With Acute Liver Failure: Another Brick in the Wall in the Current Management?
No abstract available (Source: Journal of Pediatric Gastroenterology and Nutrition)
Source: Journal of Pediatric Gastroenterology and Nutrition - June 1, 2021 Category: Gastroenterology Tags: Invited Commentaries Source Type: research

Automated Enteropathy: Discovering the Potential of Machine Learning in Environmental Enteropathy
No abstract available (Source: Journal of Pediatric Gastroenterology and Nutrition)
Source: Journal of Pediatric Gastroenterology and Nutrition - June 1, 2021 Category: Gastroenterology Tags: Invited Commentaries Source Type: research

The First Documented Case of Pediatric Colonic Pseudolipomatosis in a 15-Year-old Girl
No abstract available (Source: Journal of Pediatric Gastroenterology and Nutrition)
Source: Journal of Pediatric Gastroenterology and Nutrition - April 24, 2021 Category: Gastroenterology Tags: Video of the Month Source Type: research

Diet Advancement Based on Repeat Upper Gastrointestinal Endoscopies After Removal of an Esophageal Button Battery
No abstract available (Source: Journal of Pediatric Gastroenterology and Nutrition)
Source: Journal of Pediatric Gastroenterology and Nutrition - April 24, 2021 Category: Gastroenterology Tags: Image of the Month Source Type: research

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
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 sedentar...
Source: Journal of Pediatric Gastroenterology and Nutrition - April 24, 2021 Category: Gastroenterology Tags: Society Paper Source Type: research

Intestinal Microbiome in Preterm Infants Influenced by Enteral Iron Dosing
Objectives: 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. Study Design: Longitudinal stool collection in 80 VLBW infants were conducted up to 2 months postnatally in a prospective study. The 16S rRNA regions V4 was used to calculate microbiome compositions and the Piphillin software was used for bacterial functional prediction. Linear mixed effect models and Wilcoxon rank-sum tests were performed to examine the relationships between initial EIS dosage and stool microbiome and bacterial funct...
Source: Journal of Pediatric Gastroenterology and Nutrition - April 24, 2021 Category: Gastroenterology Tags: Original Articles: Nutrition Source Type: research

Enteral Feeding and Necrotizing Enterocolitis: Does Time of First Feeds and Rate of Advancement Matter?
Conclusions: In VLBWI, there was no association between an early initial EF and NEC, although delaying it was associated with less NEC/death. A slower FAR was associated with lower risk of both outcomes. (Source: Journal of Pediatric Gastroenterology and Nutrition)
Source: Journal of Pediatric Gastroenterology and Nutrition - April 24, 2021 Category: Gastroenterology Tags: Original Articles: Nutrition Source Type: research

Comparison of the Effect of Holder Pasteurization and High-Pressure Processing on Human Milk Bacterial Load and Bioactive Factors Preservation
Objectives: 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. Methods: Human milk samples discarded by the Public Mothers’ milk bank (Montreal, Canada) for bacterial purpose were pooled (n = 6) and pasteurized either by heating in a water bath (62.5°C, 30 minutes) or by HPP treatment (425 MPa, four cycles of 6 minutes, initial milk temperature of 4°C or 37°C). Bacterial load, lysozyme activity, and levels of immunoglobulins, lactoferrin, lipase, and 26 cytok...
Source: Journal of Pediatric Gastroenterology and Nutrition - April 24, 2021 Category: Gastroenterology Tags: Original Articles: Nutrition Source Type: research

Recommendations for Transgender and Gender Nonconforming Adolescents and Young Adults With Inflammatory Bowel Disease
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. (Source: Journal o...
Source: Journal of Pediatric Gastroenterology and Nutrition - April 24, 2021 Category: Gastroenterology Tags: Short Communications: Gastroenterology: Inflammatory Bowel Disease Source Type: research

Health and Financial Burdens Associated With Venous Thrombosis in Hospitalized Children With Inflammatory Bowel Disease
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 admissi...
Source: Journal of Pediatric Gastroenterology and Nutrition - April 24, 2021 Category: Gastroenterology Tags: Short Communications: Gastroenterology: Inflammatory Bowel Disease Source Type: research

Venous Thromboembolism in Pediatric Inflammatory Bowel Disease: A Case-Control Study
The objectives of this study were to characterize pediatric IBD patients with VTE and determine risk factors. Methods: This was a nested case-control study comparing hospitalized children with IBD diagnosed with VTE to those without VTE over a decade at a large referral center. Standard descriptive statistics were used to describe the VTE group. Multivariable conditional logistic regression was used to assess risk factors. Results: Twenty-three cases were identified. Central venous catheter (CVC) presence (odds ratio [OR] 77.9; 95% confidence interval [CI]: 6.9--880.6; P  (Source: Journal of Pediatric Gastr...
Source: Journal of Pediatric Gastroenterology and Nutrition - April 24, 2021 Category: Gastroenterology Tags: Original Articles: Gastroenterology: Inflammatory Bowel Disorders Source Type: research

The Impact of Vitamin D on Response to Anti-tumor Necrosis Factor-α Therapy in Children With Inflammatory Bowel Disease
Objectives: 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-α (anti-TNF) therapy is not established. Methods: This retrospective study evaluated pediatric IBD patients who had 25(OH)D levels drawn within 3 months of initiating infliximab and/or adalimumab treatment. Demographic...
Source: Journal of Pediatric Gastroenterology and Nutrition - April 24, 2021 Category: Gastroenterology Tags: Original Articles: Gastroenterology: Inflammatory Bowel Disorders Source Type: research

Safety of Biological Therapy in Children With Inflammatory Bowel Disease
Conclusions: Our findings confirm a good safety profile of biologics. Infusion reactions to IFX administration remain one of the main issues, significantly linked to its immunogenicity and consequently with an impact on its efficacy and durability. (Source: Journal of Pediatric Gastroenterology and Nutrition)
Source: Journal of Pediatric Gastroenterology and Nutrition - April 24, 2021 Category: Gastroenterology Tags: Original Articles: Gastroenterology: Inflammatory Bowel Disorders Source Type: research

Mucosal and Histologic Healing in Children With Inflammatory Bowel Disease Treated With Antitumor Necrosis Factor-Alpha
Conclusions: We reported a real-life experience arising from a large cohort of pediatric IBD who received ATA scheduled treatment. Less than half of patients with CD and only a little>50% of UC patients achieved MH. Microscopical inflammation was observed in 18.8% CD and 26.7% UC patients who achieved MH. Overall, MH and HH rates appear lower compared to previously published data. (Source: Journal of Pediatric Gastroenterology and Nutrition)
Source: Journal of Pediatric Gastroenterology and Nutrition - April 24, 2021 Category: Gastroenterology Tags: Original Articles: Gastroenterology: Inflammatory Bowel Disorders Source Type: research

Integration of eHealth Into Pediatric Inflammatory Bowel Disease Care is Safe: 3 Years of Follow-up of Daily Care
Conclusions: I-eHealth is comparably with results from eHealth under RCT supervision. (Source: Journal of Pediatric Gastroenterology and Nutrition)
Source: Journal of Pediatric Gastroenterology and Nutrition - April 24, 2021 Category: Gastroenterology Tags: Original Articles: Gastroenterology: Inflammatory Bowel Disorders Source Type: research

Type 2 Immunity and Age Modify Gene Expression of Coronavirus-induced Disease 2019 Receptors in Eosinophilic Gastrointestinal Disorders
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 eos...
Source: Journal of Pediatric Gastroenterology and Nutrition - April 24, 2021 Category: Gastroenterology Tags: Short Communication: Gastroenterology: Eosinophilic GI Disorders Source Type: research

Long-term Follow-up for Missed Cases of Eosinophilic Esophagitis in Children With Previous Foreign Body in the Esophagus
Conclusions: Children with a foreign body in the esophagus are at risk of having EoE. Biopsies should be taken during foreign body removal and questions about swallowing problems and allergic diseases should be carefully explored also in children who do not need EGD because of spontaneous release. (Source: Journal of Pediatric Gastroenterology and Nutrition)
Source: Journal of Pediatric Gastroenterology and Nutrition - April 24, 2021 Category: Gastroenterology Tags: Original Articles: Gastroenterology: Eosinophilic GI Disorders Source Type: research

Deamidated Gliadin Antibodies: Do They Add to Tissue Transglutaminase-IgA Assay in Screening for Celiac Disease?
Conclusions: DGP-IgG assay did not add to the performance of TTG-IgA. DGP-IgG titer correlated with enteropathy. The diagnosis of CD can be made in asymptomatic T1D child with TTG-IgA titer>10 times ULN and positive endomyseal antibodies. (Source: Journal of Pediatric Gastroenterology and Nutrition)
Source: Journal of Pediatric Gastroenterology and Nutrition - April 24, 2021 Category: Gastroenterology Tags: Original Articles: Gastroenterology: Celiac Disease Source Type: research

Diagnostic Value of Persistently Low Positive TGA-IgA Titers in Symptomatic Children With Suspected Celiac Disease
Objectives: 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. Methods: We retrospectively analyzed children with symptoms or signs of CD, not eligible for a no-biopsy approach. We included children with at least 2 TGA-IgA measurements, endomysial antibody (EMA) assessment and esophagogast...
Source: Journal of Pediatric Gastroenterology and Nutrition - April 24, 2021 Category: Gastroenterology Tags: Original Articles: Gastroenterology: Celiac Disease Source Type: research

Association Between Celiac Disease and Autism Spectrum Disorder: A Systematic Review
Conclusions: Most studies assessing an association between CD and ASD are at risk for systematic and/or random error. A potential link has, however, been shown in a handful of high-quality studies, and, therefore, this comorbidity cannot be ruled out. Future studies should recruit larger sample sizes, include precise definitions of CD and ASD, and exclude patients with ASD on a gluten-free diet. (Source: Journal of Pediatric Gastroenterology and Nutrition)
Source: Journal of Pediatric Gastroenterology and Nutrition - April 24, 2021 Category: Gastroenterology Tags: Original Articles: Gastroenterology: Celiac Disease Source Type: research

The 21st Century CURES Act in Pediatric Gastroenterology: Problems, Solutions, and Preliminary Guidance
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 release...
Source: Journal of Pediatric Gastroenterology and Nutrition - April 24, 2021 Category: Gastroenterology Tags: Short Communications: Gastroenterology Source Type: research

New Guidance on Cytochrome P450 2C19 Phenotype-based Use of Proton Pump Inhibitors
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 r...
Source: Journal of Pediatric Gastroenterology and Nutrition - April 24, 2021 Category: Gastroenterology Tags: Short Communications: Gastroenterology Source Type: research