Arch Argent Pediatr
December 2024
The goal of the treatment is to relieve symptoms, achieve duodenal mucosal healing, avoid long term complications, and ensure children´s appropriate growth, for which it´s necessary to follow a lifelong, nutritionally complete and healthy gluten free diet (GFD). The Celiac Disease Working Group of the Gastroenterology Committee of the Sociedad Argentina de Pediatría developed this guide based on expert consensus, aimed at gastroenterologists, pediatricians and primary care physicians with the objective of updating the following topics: Treatment. Definition of gluten free food.
View Article and Find Full Text PDFArch Argent Pediatr
November 2024
Celiac disease is a chronic condition that affects approximately 1% of the world's population, becoming a public health problem. The numerous publications and international guides published in recent years make it necessary to update aspects related to its diagnosis. Highly sensitive and specific serological determinations have allowed the identification of the clinical polymorphism.
View Article and Find Full Text PDFCow's milk protein can cause food allergy. The different mechanisms of action involved, the clinical variability depending on the stage of pediatric life in which it manifests, leads to difficulties in its approach, with the risk of under- or over-diagnosis. Professionals from various areas intervene in this process and their interaction is recommended.
View Article and Find Full Text PDFThe treatment of cow's milk protein allergy is based on the complete elimination of cow's milk protein from the diet. To achieve remission of symptoms and future tolerance, exclusion must be total. In formula fed infants the extensively hydrolysed formula is the most appropriate option in mild or moderate forms, while those based on amino acids are reserved for the most severe cases.
View Article and Find Full Text PDFAim: Infant gastroesophageal reflux is mostly benign; however, when associated with complications like failure to thrive, it may be indicative of gastroesophageal reflux disease. There are currently several unmet needs pertaining to the management of infant gastroesophageal reflux (disease). Reflux in infants is mostly composed of breast milk or formula, so this population is significantly different to older children and adults.
View Article and Find Full Text PDFBackground: Conventional therapy can result in remission in mild-moderate pediatric Crohn's disease (CD). However, some patients experience loss of response to biological drugs despite increased dosage.
Methods: We planned to determine that CD exclusion diet plus partial enteral nutrition offers additional benefits in asymptomatic children with CD having elevated fecal calprotectin.
Unlabelled: To describe the behavior and characteristics of children with diagnosis of graft versus host disease (GVHD) with liver-intestinal involvement.
Methods: Retrospective cohort study of pediatric patients with history of hematopoietic stem cell transplantation for diagnosis of GVHD with gastrointestinal (GI) or liver involvement, from 2 pediatric centers.
Results: Between 2007 and 2017, 57 pediatric patients presented with liver or intestinal GVHD; 74% with GI GVHD, 11% with liver GVHD, and 15% with liver-intestinal involvement.
Introduction: Ulcerative colitis (UC) is a chronic inflammatory disease that compromises the colon, affecting the quality of life of individuals of any age. In practice, there is a wide spectrum of clinical situations. The advances made in the physio pathogenesis of UC have allowed the development of new, more effective and safer therapeutic agents.
View Article and Find Full Text PDFPurpose: To analyze the characteristics of pediatric inflammatory bowel disease (IBD) over the past three decades in Argentina and determine if there are differences between the first two decades and the past decade.
Methods: We conducted a retrospective multicenter analytical study in children with IBD between 0 and 18 years of age diagnosed between 1987 and 2017 in three tertiary health centers in Argentina. The evaluation included clinical characterization, endoscopy, histology, and imaging data together with therapeutic strategies.
In recent decades, a higher prevalence, persistence, and severity of cow's milk protein allergy (CMPA) have been observed. Different hypotheses have been proposed in relation to potential responsible mechanisms, with emphasis on the role of the microbiota in the induction and maintenance of immune tolerance as well as the importance of establishing a healthy microbiota in an early manner through the promotion of breastfeeding, vaginal delivery, rational use of antibiotics and proton pump inhibitors, along with an early introduction of varied foods. The use of probiotics and allergenspecific immunotherapy (AIT) come up as the treatment strategies with the greatest evidence in favor of tolerance acquisition.
View Article and Find Full Text PDFLactose is the main carbohydrate present in human milk. It is a disaccharide made up of glucose and galactose. It is produced in the mammary glands, regardless of maternal diet.
View Article and Find Full Text PDFGraft versus host disease is a serious complication that occurs following bone marrow transplant with significant morbidity and mortality. The gold standard to diagnose gastrointestinal graft versus host disease is upper and lower gastrointestinal endoscopy with histological validation. The development of intramural duodenal hematoma is a rare complication associated with this procedure.
View Article and Find Full Text PDFIntroduction: Food allergies affect mostly children in their first years of life. Epidemiological data obtained in Argentina are scarce.
Objectives: To determine offending foods and describe the prevalence and characteristics of patients with food allergy in an Argentine pediatric population.
Gastroenterology
January 2021
Gastroenterology
January 2021
Background & Aims: A better understanding of prognostic factors in ulcerative colitis (UC) could improve patient management and reduce complications. We aimed to identify evidence-based predictors for outcomes in pediatric UC, which may be used to optimize treatment algorithms.
Methods: Potential outcomes worthy of prediction in UC were determined by surveying 202 experts in pediatric UC.
In recent years, the evidence has demonstrated the relevance of the gut microbiota in an individual's health. The dynamics of an early colonization and the establishment of a community of plenty, diverse, and healthy microorganisms from a vaginal delivery and breastfeeding are critical for the development of a healthy immune matrix. The objective of this review is to describe the available evidence on microbiota development in the first year of life and the current possibilities offered by prebiotics, probiotics, symbiotics, and postbiotics during such critical stage of life.
View Article and Find Full Text PDFJuvenile polyposis syndrome is a rare autosomal dominant condition characterized by multiple hamartomatous polyps throughout the gastrointestinal tract. Juvenile polyposis of infancy is a generalized severe form of juvenile polyposis syndrome associated with a poor prognosis. A 47-month-old female infant presented initially with gastrointestinal bleeding and protein-losing enteropathy at 4 months of age.
View Article and Find Full Text PDFMénétrier's disease is a protein losing gastroenteropathy. Defined as a rare entity with an unknown cause, most of the reported cases have been associated with viral infections. In pediatric patients, it is characterized by an acute onset with a benign and self-limiting course.
View Article and Find Full Text PDFIntroduction: Cow's milk protein allergy (CMPA) is the most common food allergy in pediatrics. In Argentina, the prevalence of this disease has been evaluated in a few trials.
Objectives: To estimate the prevalence of CMPA and describe its variation throughout a period of 11 years.
Introduction: Inflammatory bowel disease (IBD) includes ulcerative colitis (UC) and Crohn's disease (CD). IBD diagnosis has become increasingly common in pediatrics but its incidence is unknown in Argentina. The objective of this study was to determine the annual incidence of IBD in children and adolescents younger than 18 years in Argentina, its epidemiological aspects, and clinical presentations.
View Article and Find Full Text PDFIntroduction: Cow's milk protein allergy is the most common allergy in pediatrics. Immunoglobulin E (IgE)-mediated cow's milk allergy poses a higher risk for life and a worse prognosis.
Objetives: To describe the course of IgE-mediated cow's milk protein allergy and risk factors associated with disease persistence.
J Pediatr Gastroenterol Nutr
January 2017
Background: Very early onset inflammatory bowel disease (VEOIBD) (inflammatory bowel disease [IBD] before 6 years of age) may manifest as a monogenic disease affecting the gastrointestinal tract. Syndromic diarrhea/trichohepatoenteric syndrome (SD/THE), a rare disorder caused by alteration of a complex involved in RNA degradation, has been reported to present with some degree of colitis and in some cases an IBD-like presentation.
Methods: We reviewed clinical and biological data of 4 previously published cases and added detailed data of 2 new cases of SD/THE with an IBD-like presentation.
J Pediatr Gastroenterol Nutr
September 2017
Objectives: The aim of the study was to determine whether esophageal baseline impedance (BI) values in children could be predictive of esophagitis.
Materials And Methods: Multichannel intraluminal impedance (MII) tracings of children 3 to 17 years of age suspected of having gastroesophageal reflux and esophagitis, who had also undergone upper endoscopy with multiple esophageal biopsies, were reviewed. Patients with eosinophilic esophagitis were excluded.
Intestinal vascular malformations, especially those in the right colon, are a frequent cause of lower gastrointestinal bleeding in adults, but they are a very rare condition in children. Symptoms include acute hemorrhage, intestinal obstruction, or chronic anemia of uncertain etiology, which is the most frequent form of presentation but the most difficult to diagnose and thus properly treat. We report the case of an 11 year old boy admitted to the Emergency Room with abdominal pain, vomits, hemodynamic decompensation, who required expansion and blood transfusion.
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