关键词： Crohn disease   epidemiology   family history   pediatrics   ulcerative colitis  

摘要： Objectives: The aim of the study was to prospectively study changes in prevalence of positive family history (FH+) in pediatric-onset inflammatory bowel disease (IBD) in contrast to previously published cross-sectional data. Methods: An observational cohort study was performed using a prospective pediatric-onset IBD database including 485 patients with disease duration >= 10 years as of December 2016. Proband characteristics and FH+ were obtained at diagnosis and subsequently from the database, medical records, and follow-up telephone interviews in 2006 and 2016. Results: Updated 2016 information was obtained from 322 (66%) patients and included in analysis with median follow-up of 18 years (interquartile range 14, 26). Prevalence of FH+ increased from 13.7% at diagnosis to 26.6% at 20 years for first-degree relatives and from 38.5% to 52.2% for all relatives. At 20-year follow-up, an additional 10.0% of probands had a sibling, 6.1% had a parent, 1.9% had a grandparent, and 4.5% had a cousin diagnosed with IBD. FH+ at diagnosis was associated with greater risk for additional FH+ at 20 years (43% vs 22%, P < 0.001). Non-Jewish Caucasians had significantly lower risk of a FH+ compared to Jewish Caucasians (P = 0.002), but similar risk to African Americans (P = 0.55). FH+ at diagnosis was not associated with disease type (P = 0.33) or age at diagnosis (P = 0.24). Conclusions: This prospective study documents changes in family history of IBD in pediatric-onset IBD patients over time. Prevalence of FH+ increased for first-degree and all relatives at 20 years by 12.9% and 13.7%, respectively. FH+ at diagnosis was associated with a 2-fold greater likelihood of subsequent FH+ at 20 years.

关键词： First Year of Life   Risk Factors   Sibling   Cohort Studies  

摘要： BACKGROUND & AIMS: We performed a population-based study to determine whether there was an increased risk of inflammatory bowel diseases (IBD) in persons with critical events at birth and within 1 year of age. METHODS: We collected data from the University of Manitoba IBD Epidemiology Database, which contains records on all Manitobans diagnosed with IBD from 1984 through 2010 and matched controls. From 1970 individuals' records can be linked with those of their mothers, so we were able to identify siblings. All health care visits or hospitalizations during the neonatal and postnatal periods were available from 1970 through 2010. We collected data on infections, gastrointestinal illnesses, failure to thrive, and hospital readmission in the first year of life and sociodemographic factors at birth. From 1979, data were available on gestational age, Apgar score, neonatal admission to the intensive care unit, and birth weight. We compared incident rate of infections, gastrointestinal illnesses, and failure to thrive between IBD cases and matched controls as well as between IBD cases and siblings. RESULTS: Data on 825 IBD cases and 5999 matched controls were available from 1979. Maternal diagnosis of IBD was the greatest risk factor for IBD in offspring (odds ratio [OR], 4.53;95% confidence interval [CI], 3.08-6.67). When we assessed neonatal events, only being in the highest vs lowest socioeconomic quintile increased risk for later development of IBD (OR, 1.35;95% CI, 1.01-1.79). For events within the first year of life, being in the highest socioeconomic quintile at birth and infections (OR, 1.39;95% CI, 1.09-1.79) increased risk for developing IBD at any age. Infection in the first year of life was associated with diagnosis of IBD before age 10 years (OR, 3.06;95% CI, 1.07-8.78) and before age 20 years (OR, 1.63;95% CI, 1.18-2.24). Risk for IBD was not affected by gastrointestinal infections, gastrointestinal disease, or abdominal pain in the first year of life. CONCLU

关键词： Inflammatory bowel disease   Crohn's disease   Ulcerative colitis   Genetic screening   Serology   Laboratory monitoring  

摘要： Inflammatory bowel disease (IBD) comprises a group of chronic, intestinal inflammatory disorders, including ulcerative colitis and Crohn's disease. IBD is characterized by periods of relapse and remission. Long-term progressive intestinal inflammation can result in severe and devastating complications, such as intestinal strictures and/or fistulae. Immune suppressive medications with potent side effects are often used to control inflammation and limit disease activity. Laboratory tests guide various decisions in clinical management of IBD. We discuss tests used to diagnose IBD, assess for relapse or remission, monitor the effectiveness of therapeutic regimen, screen for the maintenance of health, and diagnose or prevent complications.

关键词： Viral Infection   Thiopurine Therapy   Ulcerative Colitis   Crohn's Disease  

摘要： BACKGROUND & AIMS: The risk of herpes zoster virus infection is increased among patients with inflammatory bowel diseases (IBD). The herpes zoster vaccine (HZV) is therefore recommended for these patients, but little is known about its effectiveness, resulting in low use. METHODS: We conducted a retrospective cohort study using data from the national veterans Affairs Healthcare System (VAHS) from January 1, 2000 through June 30, 2016. We collected data from 39,983 veterans with IBD who had not received the HZV by an age of 60 years. The follow-up period started at age 60 or the date of first IBD medication prescription (whichever was later) and ended with the earliest diagnosis of herpes zoster infection, the end of the study period, or date of death. We identified veterans who received the HZV during the follow-up period and compared the incidence of herpes zoster between vaccinated vs unvaccinated patients. We performed multivariable Cox regression with time-dependent analysis to determine the risk of herpes zoster associated with vaccination status in the entire cohort and stratified by IBD medication. RESULTS: We identified 7170 patients who received the HZV during the follow-up period (17.9% of total cohort;96.6% male and 94.2% Caucasian). The crude incidence rate of herpes zoster infection during the follow-up period for unvaccinated patients was 6.97/1000 person-years and for vaccinated patients was 4.09/1000 person-years. Vaccination was associated with significantly lower risk of herpes zoster infection, compared to lack of vaccination (adjusted hazard ratio, 0.54;95% CI, 0.44 - 0.68). CONCLUSION: Vaccination was associated with a significantly reduced risk of herpes zoster infection among veterans with IBD. This vaccine is therefore effective in patients with IBD, but underused.

关键词： Microbiome   Inflammatory Bowel Disease   Host Genetics   Mucosal Immunity   Preclinical Therapies  

摘要： The intestinal microbiota is a dynamic community of bacteria, fungi, and viruses that mediates mucosal homeostasis and physiology. Imbalances in the microbiome and aberrant immune responses to gut bacteria can disrupt homeostasis and are associated with inflammatory bowel diseases (IBDs) in humans and colitis in mice. We review genetic variants associated with IBD and their effects on the intestinal microbiome, the immune response, and disease pathogenesis. The intestinal microbiome, which includes microbial antigens, adjuvants, and metabolic products, affects the development and function of the intestinal mucosa, influencing inflammatory responses in the gut. Therefore, strategies to manipulate the microbiome might be used in treatment of IBD. We review microbe-based therapies for IBD and the potential to engineer patients' intestinal microbiota. We discuss how studies of patients with IBD and mouse models have advanced our understanding of the interactions between genetic factors and the gut microbiome, and challenges to the development of microbe-based therapies for IBD.

关键词： traveller's diarrhoea   inflammatory bowel disease   stool microbiology  

摘要： Diarrhoea that occurs during or after recent travel is predominantly infectious in nature;however, in atypical or prolonged cases a broader range of aetiologies for diarrhoea must be considered, and a careful history and examination may reveal clues to more sinister causes of diarrhoea. We report two cases in which a recent travel history and a positive stool culture or polymerase chain reaction testing for bacterial pathogens delayed the diagnosis of ulcerative colitis. As a result of severe inflammatory bowel disease, colectomy was the final result in both cases. Early consideration of causes other than infection for traveller's diarrhoea may prevent unnecessary morbidity in young patients.

关键词： Children   Computed tomography   Infant   Inflammatory bowel disease   Magnetic resonance imaging   Ultrasound  

摘要： The above article was published online with incorrect author name. The right spelling should be Damjana Kljucevsek instead of Damjana Kjucevsek. The correct name is presented here.

关键词： Ankylosing spondylitis   Anti-TNF-alfa   Paradoxical adverse events   Inflammatory bowel disease  

摘要： Objective: The aim of this study was to determine whether there is any association with anti-tumor necrosis factor (TNF) agent administration and development of new-onset inflammatory bowel disease (IBD) in ankylosing spondylitis (AS) patients. Methods: Records of the patients who met 1984 modified New York criteria for AS between 1998 and 2016 at Rheumatology Department were evaluated retrospectively and data about the patients, IBD properties and medication were obtained. Results: Among 420 patients, 310 were male, the average age was 42.9 +/- 1.3 years, average disease duration was 16.7 +/- 10.4 years. Anti-INF agents were in use by 154 patients, 52 patients were receiving etanercept (ETN), infliximab (INF), adalimumab (ADA). and golimumab (GO) treatments were ongoing in 50, 41, and 11 patients, respectively. New-onset IBD developed in 10 patients: 3 from the group treated with non-anti-INF drugs (1.1%) and 7 from the group treated with anti-TNF agents (4.5%) fp = 0.042). No significant difference was detected between three anti-INF agent forms in relation with the risk of 1BD onset. In AS patients, existence of familial AS (OR 4.69 {95%CI 1.28-17.19, p = 0.020) and anti-TNF agent treatment (OR 4.17 (95%CI 1.06-16.38, p = 0.041) were independent risk factors for new-onset IBD development. Conclusion: Despite the increased risk of new-onset IBD development during the course of AS, paradoxical response to anti-TNF drugs must also be considered as a source that triggers onset of IBD.