Characteristics and management of eosinophilic esophagitis in Australasian children: a decade of experience.

Background: The frequency of EoE has been increasing in Northern Hemisphere cohorts, yet there is a scarcity of data in our region. Regional climatic factors, and lifestyle habits may influence the presentation of EoE, and appropriate management is crucial to prevent complications. WIth this is mind we undertook the first comprehensive multisite study of EoE in Australasian children.

Arterial structure and function in children with inflammatory bowel disease.

Background And Aim: People with inflammatory bowel disease (IBD) have an increased risk of cardiovascular disease, including in younger adulthood. This may arise in part from chronic, systemic low-grade inflammation. The process of atherosclerosis may begin in childhood.

Distinct diagnostic trajectories in NBAS-associated acute liver failure highlights the need for timely functional studies.

Variants of uncertain significance (VUS) are commonly found following genomic sequencing, particularly in ethnically diverse populations that are underrepresented in large population databases. Functional characterization of VUS may assist in variant reclassification, however these studies are not readily available and often rely on research funding and good will. We present four individuals from three families at different stages of their diagnostic trajectory with recurrent acute liver failure (RALF) and biallelic variants, confirmed by either trio analysis or cDNA studies.

Chronic diarrhoea in children: A practical algorithm-based approach.

Diarrhoea is a leading cause of morbidity and mortality world-wide. Most diarrhoeal episodes are acute and infectious in origin. Diarrhoea lasting for longer than 4 weeks with no discernible infectious aetiology warrants thorough evaluation.

The burden of surgery and postoperative complications in children with inflammatory bowel disease.

Background: Pediatric inflammatory bowel disease (IBD) may be associated with a higher burden of surgery and postoperative complications. This study aimed to measure the burden in pediatric IBD over a 20-year period in a large tertiary referral center.

Methods: A retrospective review was conducted of children diagnosed with IBD between 1996 and 2015, with a focus upon operative intervention (excluding endoscopy) and postoperative outcomes.

Secondary Loss of Response to Infliximab in Pediatric Crohn Disease: Does It Matter How and When We Start?

Objectives: A significant proportion of children with Crohn disease develop a secondary loss of response (LOR) to infliximab. Our aim was to study the impact of initial treatment strategies on secondary LOR.

Methods: We reviewed the medical records of children with Crohn disease who received scheduled maintenance infliximab therapy for at least 12 months.

Paediatric MRCP: 10 year experience with 195 patients.

Purpose: Magnetic resonance cholangiopancreatography (MRCP) has now largely substituted endoscopic retrograde cholangiopancreatography (ERCP) in evaluating the biliary tree in adults giving its high sensitivity and specificity. Whilst smaller series published to date suggests this may be extrapolated to the paediatric population, its routine use in children is still debatable. The aim of our study is therefore to review the utility of MRCP in a large series of paediatric patients.

Emerging management concepts for eosinophilic esophagitis in children.

Eosinophilic esophagitis (EoE) is a newly recognized condition that appears to be increasing in incidence for as yet unknown reasons. It can occur at any age and presents both to gastroenterologists and allergists. Clinical manifestations range from gastrointestinal symptoms (vomiting, feeding difficulties, dysphagia or food bolus impaction) to co-existing atopic conditions (asthma, allergic rhinitis or eczema).

Drug rash with eosinophilia and systemic symptoms secondary to sulfasalazine.

A severe cutaneous eruption in an unwell patient can be a major cause of physician anxiety. With numerous differential diagnoses, an early accurate diagnosis can be challenging. infectious causes are the most important to exclude in a timely manner and drug rash and eosinophilia with systemic symptoms (DRESS) is another differential diagnosis that should be considered in children.

Ursodeoxycholic acid's role in avoiding diversionary surgery in idiopathic fibrosing pancreatitis.

Obstructive jaundice in childhood is rare but a cause of great concern and warrants aggressive investigation into its aetiology. Idiopathic fibrosing pancreatitis (IFP) is a rare cause of this phenomenon and is presently a diagnosis of exclusion with lymphoma a main differential diagnosis. IFP appears to be a self limiting occurrence and as a result the previous gold standard of therapy of surgical diversion may ultimately be unnecessary.