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- Käppi, Timo, 1975, et al.
(författare)
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Collagenous Gastritis in Children: Incidence, Disease Course, and Associations With Autoimmunity and Inflammatory Markers.
- 2020
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Ingår i: Clinical and translational gastroenterology. - : Ovid Technologies (Wolters Kluwer Health). - 2155-384X. ; 11:8
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Tidskriftsartikel (refereegranskat)abstract
- Collagenous gastritis (CG), a rare disorder of unknown etiology, has been postulated to have immune-mediated mechanisms. We investigated (i) the incidence and prevalence of CG in a pediatric population; (ii) the clinical, endoscopic, and histologic characteristics of childhood-onset CG; and (iii) the evidence for autoimmunity and/or inflammatory activity in these patients.Clinical, endoscopic, and histologic data were reviewed longitudinally in a population-based Swedish cohort of 15 patients with childhood-onset CG diagnosed in the period 2008-2019. A set of 11 autoantibodies, 4 blood inflammatory biomarkers, and the human leukocyte antigen DQ2/DQ8 genotype was analyzed cross-sectionally.The incidence rate of childhood-onset CG was 0.25/100,000 person-years, with an incidence rate ratio of girls to boys of 4.2 (95% confidence interval, 1.2-15). The prevalence of CG was 2.1/100,000 in children aged younger than 18 years. The endoscopic and histologic findings remained pathologic in all the examined patients during a median follow-up of 4.4 years. Many patients had heredity for autoimmune disorders (47%) and/or tested positive for autoantibodies (40%) or human leukocyte antigen DQ2/DQ8 (53%). No associated autoimmune comorbidities were observed. The serum levels of calprotectin and amyloid A were increased in 10/15 (67%) and 5/15 (33%) of the patients, respectively, whereas plasma C-reactive protein levels were normal in all, but 1 patient.The results indicate that childhood-onset CG is rare and has a chronic disease course. Although signs of autoimmune predisposition are frequent, early development of autoimmune comorbidities seems seldom. Serum calprotectin and amyloid A represent novel candidate biomarkers of inflammatory activity in CG (see Visual Abstract, Supplementary Digital Content 4, http://links.lww.com/CTG/A349).
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| 2. |
- Marthinsen, Lars, et al.
(författare)
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Kolonspiroketos - behandlingsbart och värt att uppmärksamma : Erfarenheter från pediatrisk praktik
- 2006
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Ingår i: Läkartidningen. - 0023-7205 .- 1652-7518. ; 103:46, s. 3600-3602
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Forskningsöversikt (refereegranskat)abstract
- This article is written to raise awareness among clinicians and pathologists regarding the existence of colonic spirochetosis. Whether this is of clinical significance is still a matter of debate. We report a series of sixteen randomly selected patients, all of paediatric age; eight of them have been reported in a previous publication (10). In one patient, spirochetes were found both in the colon and in the liver. The colon organisms were Brachyspira aalborgi, documented by antigen test; however, due to lack of material, the spirochetes in the liver could not be typed. As 10 of 13 patients recovered or improved after antibiotic treatment with clarythromycin or metronidazole, our conclusion is that Brachyspira may be pathogenic. We suggest that when a rectosigmoidoscopy/colonoscopy is performed, colonic spirochetosis should be considered, especially in the differential diagnosis to microscopic colitis.
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