Coeliac disease (CD) diagnosis is based on clinical assessment, detection of specific autoantibodies and histological examination of small intestinal biopsies. The European Society of Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) guidelines have recently been updated and recommend CD may be diagnosed without a biopsy or HLA typing in symptomatic patients with high titre IgA tissue transglutaminase antibodies (aTTG) and positive endomysial antibodies (EMA). However, the need for EMA in patients with high level aTTG has been questioned.
View Article and Find Full Text PDFHepatocellular malignant neoplasm, not otherwise specified (HCN-NOS) is a provisional entity describing a subset of rare malignant pediatric liver tumors with overlapping features of hepatoblastoma and hepatocellular carcinoma. We present a case illustration of metastatic HCN-NOS successfully treated with a backbone of hepatoblastoma chemotherapy, pulmonary metastastectomy, and liver transplantation, along with a literature review of the clinical outcomes of HCN.
View Article and Find Full Text PDFJ Pediatr Gastroenterol Nutr
November 2018
Objective: Gastrostomy insertion in pediatrics is usually used in children with complex needs and severe disability. The accessibility and acceptance of the procedure is increasing but population-based occurrence data are lacking and there is limited understanding of its use in clinical subgroups.
Methods: This birth cohort study investigated the trends in first gastrostomy insertion among a pediatric population born between 1983 and 2009 in Western Australia using linked administrative and health data collected over a 32-year period (1983-2014).
J Pediatr Gastroenterol Nutr
April 2010
Background And Aim: Celiac disease (CD) and eosinophilic esophagitis (EE) are distinct disorders with specific clinico-pathological characteristics. Recent reports suggest an association between the 2. The aim of this study was to estimate the prevalence of EE among children diagnosed with CD in our institution in the last 8 years.
View Article and Find Full Text PDFA 14-year-old boy who presented with debilitating lethargy was shown to have an elevated serum ferritin of 572 microg/L and a C282Y homozygous HFE genotype. Liver iron concentration was measured non-invasively by magnetic resonance imaging, which revealed a liver iron concentration of 59 micromol/g dry weight (children's reference range < 14). The early phenotypic expression was further investigated by screening genomic DNA for the presence of co-inherited mutations in genes responsible for non-HFE haemochromatosis.
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