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Enteropathies in children

Luther A Bartelt, David T Bolick, Richard L Guerrant
Environmental enteric dysfunction (EED, syn. environmental enteropathy (EE)) is a subclinical chronic intestinal disorder that is an emerging contributor to early childhood malnutrition. EED is common in resource-limited settings, and is postulated to consist of small intestinal injury, dysfunctional nutrient absorption, and chronic inflammation that results in impaired early child growth attainment. While there is emerging interest in the hypothetical potential for chemical toxins in the environmental 'exposome' to contribute to EED, the propensity of published data, and hence the focus of this review, implicates a critical role of environmental microbes...
January 7, 2019: Cellular and Molecular Gastroenterology and Hepatology
Mauro Batista de Morais, Giselia Alves Pontes da Silva
OBJECTIVE: To describe the current indicators of environmental enteric dysfunction and its association with linear growth deficit and the height-for-age anthropometric indicator. DATA SOURCES: Narrative review with articles identified in PubMed and Scopus databases using combinations of the following words: environmental, enteric, dysfunction, enteropathy, and growth, as well as the authors' personal records. DATA SYNTHESIS: In the last 15 years, new non-invasive markers have been investigated to characterize environmental enteric dysfunction; however, the best tests to be used have not yet been identified...
January 7, 2019: Jornal de Pediatria
Julie M Long, Prasenjit Mondal, Jamie E Westcott, Leland V Miller, M Munirul Islam, Mondar Ahmed, Mustafa Mahfuz, Tahmeed Ahmed, Nancy F Krebs
Background: Environmental enteric dysfunction (EED), a chronic inflammatory disorder of the small bowel, is suspected to impair absorption of micronutrients, including zinc. Objective: The objective of this study was to compare zinc absorption from micronutrient powder (MNP) over a range of zinc doses in young children screened for EED with use of the lactulose:mannitol ratio (L:M). Methods: Bangladeshi children aged 18-24 mo, grouped according to high and low L:M (≥0...
January 9, 2019: Journal of Nutrition
Nanami Shigetomi, Kenta Kamiya, Toru Takamori, Naoki Yoshimura, Sayaka Ozawa, Keiichi Hirono, Fukiko Ichida, Masato Taguchi
The purpose of this study was to determine the serum protein binding of tadalafil in children with protein-losing enteropathy (PLE) and to evaluate the specific binding of the drug to human serum-derived proteins in vitro. Seventeen serum samples from two PLE patients used after biochemical tests were collected, and the unbound fraction of tadalafil was determined by an ultrafiltration method. The serum albumin concentrations observed in patients #1 and #2 were 2.4-4.2 and 2.9-3.5 g/dL, respectively. The ranges of unbound fraction of tadalafil in patients #1 and #2 were 3...
2019: Biological & Pharmaceutical Bulletin
Joshua N Edokpayi, Elizabeth T Rogawski, David M Kahler, Courtney L Hill, Catherine Reynolds, Emanuel Nyathi, James A Smith, John O Odiyo, Amidou Samie, Pascal Bessong, Rebecca Dillingham
Consumption of microbial-contaminated water can result in diarrheal illnesses and enteropathy with the heaviest impact upon children below the age of five. We aimed to provide a comprehensive analysis of water quality in a low-resource setting in Limpopo province, South Africa. Surveys were conducted in 405 households in rural communities of Limpopo province to determine their water-use practices, perceptions of water quality, and household water-treatment methods. Drinking water samples were tested from households for microbiological contamination...
February 2018: Water
Roxana Maxim, Alina Plesa, Carol Stanciu, Irina Girleanu, Evelina Moraru, Anca Trifan
BACKGROUND/AIMS: The relationship between Helicobacter pylori and celiac disease (CD) remains controversial. The aim of this study was to assess the prevalence and risk factors for H. pylori infection among children diagnosed with CD. MATERIALS AND METHODS: This study included 70 patients diagnosed with CD at a tertiary referral center in Romania. Age, gender, and indicators of environmental conditions were evaluated via interviews with the childrens caretakers...
December 12, 2018: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
Bilge Sahin Akkelle, Engin Tutar, Ozlem K Sengul, Cigdem A Celikel, Deniz Ertem
Protein-losing enteropathy may develop as a complication of a wide spectrum of diseases. Three cases of giardiasis that presented with acute onset of hypoalbuminemia were documented, and resolution of protein loss after treatment was also confirmed. Thus, chronic enteric infections should be considered as an etiology of severe intestinal protein loss, particularly in children.
December 2018: Pediatric Infectious Disease Journal
James P Wirth, Brenda Kitilya, Nicolai Petry, George PrayGod, Stephen Veryser, Julius Mngara, Christian Zwahlen, Frank Wieringa, Jacques Berger, Mercedes de Onis, Fabian Rohner, Elodie Becquey
Recent evidence suggests that enteropathy of the gut due to environmental conditions (i.e., environmental enteropathy [EE]) in young children is negatively associated with linear growth. Using a case-control study design, we examined the potential determinants of stunting in stunted and non-stunted children 22-28 months of age. Potential determinants included inflammation biomarkers C-reactive protein, alpha-1-acid glycoprotein (AGP), and endotoxin-core antibody (EndoCAb) measured in serum samples; enteropathy markers alpha-1-antitrypsin, neopterin, myeloperoxidase (MPO) measured in stools samples; and demographic, health, feeding, and household characteristics...
November 5, 2018: American Journal of Tropical Medicine and Hygiene
R Duclaux-Loras, F Charbit-Henrion, B Neven, J Nowak, S Collardeau-Frachon, C Malcus, P F Ray, D Moshous, J Beltrand, O Goulet, N Cerf-Bensussan, A Lachaux, F Rieux-Laucat, F M Ruemmele
OBJECTIVE: Immune dysregulation, polyendocrinopathy, enteropathy, X-linked (IPEX) syndrome is an autoimmune disease caused by mutations in the forkhead box protein 3 gene (FOXP3), which encodes a key regulator of immune tolerance. The aim of this study was to describe the clinical heterogeneity of the disease in a national French cohort. METHODS: Multicenter retrospective study of patients diagnosed with IPEX syndrome caused by mutations in FOXP3. RESULTS: Thirty children from 26 families were included...
November 2, 2018: Clinical and Translational Gastroenterology
Alejandro Llanos-Chea, Alessio Fasano
In children, functional gastrointestinal disorders (FGIDs) are common at all ages. Consumption of certain foods, particularly gluten, is frequently associated with the development and persistence of FGIDs and functional abdominal pain disorders (FAPDs) in adults and children. However, this association is not well defined. Even without a diagnosis of celiac disease (CD), some people avoid gluten or wheat in their diet since it has been shown to trigger mostly gastrointestinal symptoms in certain individuals, especially in children...
October 12, 2018: Nutrients
Yannick Caron, Rathmony Hong, Ludovic Gauthier, Arnaud Laillou, Frank T Wieringa, Jacques Berger, Etienne Poirot
BACKGROUND: The adverse outcomes of malnutrition on the development of a child are well acknowledged as are the broad variety of contextual factors that may impact child nutritional status. Adequate nutrient intake and the adoption of appropriate water, sanitation and hygiene measures are largely documented for their positive influence on health. Improved sanitation and protection from human feces can significantly lower the incidence of diarrhea and environmental enteropathy. However, the impact of excessive exposure to animal feces on child health is less well documented...
October 3, 2018: Nutrients
Hung-Yu Yeh, Ming-Yao Su, Wei-Pin Lin, Ming-Wei Lai, Hsun-Ching Chao, Shih-Yen Chen, Cheng-Tang Chiu
BACKGROUND/PURPOSE: The diagnostic and therapeutic benefits of double-balloon enteroscopy (DBE) in adults are established, but few data are available on pediatric patients. The aim of this study was to evaluate the clinical efficacy and safety of DBE in pediatric patients in Taiwan. METHODS: From April 2005 to September 2015, DBE procedures performed for diagnosis or therapy of small-bowel disease in children less than 18 years of age at Linkou Chang Gung Memorial Hospital, Taiwan were evaluated...
September 26, 2018: Journal of the Formosan Medical Association, Taiwan Yi Zhi
Atakan Comba, Nadiye Barış Eren, Emre Demir
BACKGROUND/AIMS: Celiac disease (CD) is an autoimmune enteropathy that develops in individuals with genetic susceptibility as a result of a permanent sensitivity to gluten found in grains. The prevalence of CD in Turkey is between 0.3% and 1%. However, the prevalence of CD in Çorum, a city in middle Anatolia in Turkey, is unknown. The purpose of this study was to identify the prevalence of childhood CD in Çorum and to detect patients with silent and atypical CD. MATERIALS AND METHODS: The sample size was calculated using a stratified sampling method, to provide the sample number that would best represent this population...
September 2018: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
Iraj Shahramian, Ali Bazi, Alireza Sargazi
Context: Celiac disease (CD) is a common phenomenon in children with Type 1 diabetes (T1D). In the present review, we have discussed the pathogenesis, diagnostic biomarkers, risk factors, and prognosis of CD in the context of pediatric T1D. Evidence Acquisition: Literature published in Web of Science, PubMed, Scopus, Google Scholar, and Cochrane Library were scrutinized up to the end of 2017. The keywords of celiac disease, Type 1 diabetes, children, and pediatric were used in different combinations...
July 2018: International Journal of Endocrinology and Metabolism
Sedat Işıkay, Nurgül Işıkay, Hüseyin Per, Kürşat Bora Çarman, Halil Kocamaz
Işıkay S, Işıkay N, Per H, Çarman KB, Kocamaz H. Restless leg syndrome in children with celiac disease. Turk J Pediatr 2018; 60: 70-75. Celiac disease (CD) is an immune-mediated enteropathy triggered by ingestion of dietary gluten in genetically predisposed individuals. The aim of the study was to determine the prevalence of restless leg syndrome (RLS) in children with CD and to investigate the associated factors for RLS. Totally 494 children with the ages ranging between 11-18 years were included. Among those, 226 were under follow-up with CD and constituted the study group while other 268 children did not have any symptoms or signs associated with CD and established the control group...
2018: Turkish Journal of Pediatrics
Lyudmila V Savvateeva, Svetlana I Erdes, Anton S Antishin, Andrey A Zamyatnin
Coeliac disease (CD) is an autoimmune enteropathy triggered by the ingestion of gluten-containing grains in genetically predisposed individuals. Identification of CD in clinical practice is often difficult due to the manifestation of non-specific symptoms and signs, so a relatively significant proportion of CD cases remain undiagnosed. Timely detection of the disease is necessary to provide an appropriate approach to control of the disease treatment, in order to avoid potential complications. This is even more important in the case of children and adolescents, to ensure their proper growth and development...
July 27, 2018: International Archives of Allergy and Immunology
Pascale Vonaesch, Rindra Randremanana, Jean-Chrysostome Gody, Jean-Marc Collard, Tamara Giles-Vernick, Maria Doria, Inès Vigan-Womas, Pierre-Alain Rubbo, Aurélie Etienne, Emilson Jean Andriatahirintsoa, Nathalie Kapel, Eric Brown, Kelsey E Huus, Darragh Duffy, B Brett Finlay, Milena Hasan, Francis Allen Hunald, Annick Robinson, Alexandre Manirakiza, Laura Wegener-Parfrey, Muriel Vray, Philippe J Sansonetti
BACKGROUND: Globally one out of four children under 5 years is affected by linear growth delay (stunting). This syndrome has severe long-term sequelae including increased risk of illness and mortality and delayed psychomotor development. Stunting is a syndrome that is linked to poor nutrition and repeated infections. To date, the treatment of stunted children is challenging as the underlying etiology and pathophysiological mechanisms remain elusive. We hypothesize that pediatric environmental enteropathy (PEE), a chronic inflammation of the small intestine, plays a major role in the pathophysiology of stunting, failure of nutritional interventions and diminished response to oral vaccines, potentially via changes in the composition of the pro- and eukaryotic intestinal communities...
July 19, 2018: BMC Pediatrics
Touran Shahraki, Mansour Shahraki, Ivor D Hill
Introduction: A small number of overweight and obese children with celiac disease (CD) has been reported. Aim: To estimate the prevalence of obesity, underweight and normal weight in a group of Iranian pediatric patients. Material and methods: In a retrospective study from 2007 to 2015, 225 children less than 18 years old with biopsy-proven CD were enrolled. Data collected included demographic characteristics, clinical presentation, antibody titers and severity of small-bowel mucosal damage...
2018: Przegla̜d Gastroenterologiczny
Chelsea Marie, Asad Ali, Kanta Chandwe, William A Petri, Paul Kelly
Environmental enteric dysfunction (EED) refers to a subclinical disorder of intestinal function common in tropical countries and in settings of poverty and economic disadvantage. The enteropathy that underlies this syndrome is characterized by mucosal inflammation and villus blunting mediated by T cell activation. Epithelial cell disruption and microbial translocation drive systemic inflammation. EED in young children is associated geographically with growth failure, malnutrition, and greatly impaired responses to oral vaccines, notably rotavirus and poliovirus vaccines...
September 2018: Mucosal Immunology
Maša Primec, Martina Klemenak, Diana Di Gioia, Irene Aloisio, Nicole Bozzi Cionci, Andrea Quagliariello, Mario Gorenjak, Dušanka Mičetić-Turk, Tomaž Langerholc
BACKGROUND & AIMS: Celiac disease (CD) is an immune-mediated systemic disease, caused by ingestion of gluten in genetically predisposed individuals. Gut microbiota dysbiosis might play a significant role in pathogenesis of chronic enteropathies and its modulation can be used as an intervention strategy in CD as well. In this study, we aimed to identify correlations between fecal microbiota, serum tumor necrosis factor alpha (TNF-α) and fecal short-chain fatty acids (SCFAs) in healthy children and children with CD after administration of probiotic Bifidobacterium breve BR03 and B632...
June 18, 2018: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
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