@article {10443, title = {Immunohistologic analysis of the duodenal bulb: a new method for celiac disease diagnosis in children.}, journal = {Gastrointest Endosc}, volume = {88}, year = {2018}, month = {2018 Sep}, pages = {521-526}, abstract = {

BACKGROUND AND AIMS: Anti-tissue transglutaminase antibodies (anti-tTG) have simplified celiac disease (CD) diagnosis. However, in atypical forms of CD, intestinal biopsy sampling is still required. This prospective study investigates whether histologic analysis of the duodenal bulb combined with intestinal IgA anti-tTG deposit immunoassay makes CD diagnosis possible in at-risk children with low concentrations of serum anti-tTG.

METHODS: Histologic and intestinal IgA anti-tTG deposit immunoassays were used.

RESULTS: Two hundred forty-five symptomatic children positive for serum anti-tTG (>7 U/mL) were enrolled and~divided into 3 groups: extensive duodenal atrophy (n~= 209), with IgA anti-tTG deposits throughout the duodenum and high serum anti-tTG concentrations (157 {\textpm} 178 U/mL); bulb duodenal atrophy (n~= 22), with widespread IgA anti-tTG deposits in 9 and in the bulb alone in 13 and low serum anti-tTG concentrations (13.9~{\textpm} 8.7 U/mL); and normal duodenum (n~= 14), with widespread IgA anti-tTG deposits in 8 and in the bulb alone in 6 and low serum anti-tTG concentrations (10.6 {\textpm} 6.2 U/mL). All patients in the first 2 groups were diagnosed with CD and 8 from the third group. All improved after 1 year of gluten-free diet. Bulb duodenal analysis led to a 12\% (30/245) increase in CD diagnosis. No CD-related lesions were observed in the 30 control subjects.

CONCLUSIONS: In children at risk for CD, bulb duodenum biopsy sampling is essential to identify villous atrophy and detect IgA anti-tTG deposits even in absence of intestinal lesions. These mucosal autoantibodies could well represent a new standard for diagnosing CD.

}, keywords = {Adolescent, Autoantibodies, Celiac Disease, Child, Child, Preschool, Duodenum, Female, Humans, Immunoglobulin A, Immunohistochemistry, Infant, Male, Prospective Studies, Transglutaminases}, issn = {1097-6779}, doi = {10.1016/j.gie.2018.05.014}, author = {De Leo, Luigina and Villanacci, Vincenzo and Ziberna, Fabiana and Vatta, Serena and Martelossi, Stefano and Di Leo, Grazia and Zanchi, Chiara and Bramuzzo, Matteo and Giudici, Fabiola and Ventura, Alessandro and Not, Tarcisio} } @article {10828, title = {Paediatric Home Artificial Nutrition in Italy: Report from 2016 Survey on Behalf of Artificial Nutrition Network of Italian Society for Gastroenterology, Hepatology and Nutrition (SIGENP).}, journal = {Nutrients}, volume = {10}, year = {2018}, month = {2018 Sep 16}, abstract = {

Home Artificial Nutrition (HAN) is a safe and efficacious technique that insures children{\textquoteright}s reintegration into the family, society and school. Epidemiological data on paediatric HAN in Italy are not available.

AIM: to detect the prevalence and incidence of Home Parenteral Nutrition (HPN) and Home Enteral Nutrition (HEN), either via tube or mouth, in Italy in 2016.

MATERIALS AND METHODS: a specific form was sent to all registered SIGENP members and investigators of local HAN centres, inviting them to provide the requested centre{\textquoteright}s data and demographics, underlying diseases and HAN characteristics of the patients.

RESULTS: we recorded 3403 Italian patients on HAN aged 0 to 19 years from 22 centres: 2277 HEN, 950 Oral Nutritional Supplements (ONS) and 179 HPN programs. The prevalence of HEN (205 pts/million inhabitants) and HPN (16 pts/million inhabitants) has dramatically increased in Italy in the last 9 years. Neurodisabling conditions were the first indication for HEN by tube or mouth while HPN is mainly requested in digestive disorders.

CONCLUSIONS: HAN is a widespread and rapidly growing treatment in Italy, as well as in other European countries. Awareness of its extent and characteristics helps improving HAN service and patients{\textquoteright} quality of life.

}, keywords = {Adolescent, Age Factors, Child, Child Nutritional Physiological Phenomena, Child, Preschool, Enteral Nutrition, Female, Health Care Surveys, Home Care Services, Humans, Infant, Infant, Newborn, Italy, Male, Nutritional Status, Parenteral Nutrition, Home, Pediatrics, Time Factors, Young Adult}, issn = {2072-6643}, doi = {10.3390/nu10091311}, author = {Lezo, Antonella and Capriati, Teresa and Spagnuolo, Maria Immacolata and Lacitignola, Laura and Goreva, Irina and Di Leo, Grazia and Cecchi, Nicola and Gandullia, Paolo and Amarri, Sergio and Forchielli, Maria Luisa and Dipasquale, Valeria and Parma, Barbara and Gatti, Simona and Ravaioli, Elisa and Salvatore, Silvia and Mainetti, Martina and Norsa, Lorenzo and Pellegrino, Maristella and Fornaro, Martina and Fiorito, Valentina and Lanari, Marcello and Giaquinto, Ester and Verduci, Elvira and Baldassarre, Maria Elisabetta and Diamanti, Antonella} } @article {3475, title = {Hemophagocytic lymphohistiocytosis in total parenteral nutrition dependent children: description of 5 cases and practical tips for management.}, journal = {J Pediatr Hematol Oncol}, volume = {36}, year = {2014}, month = {2014 Oct}, pages = {e440-2}, abstract = {

Although total parenteral nutrition (TPN) is mandatory in children with intestinal failure, this treatment is not risk free. The main complications of TPN include catheter-related sepsis, thrombosis, hepatic cholestasis and cirrhosis, metabolic bone disease, and, rarely, reactive hemophagocytic lymphohistiocytosis (HLH). The pathogenesis of HLH in patients with TPN is not known, although some authors hypothesized that it can result from the activation of macrophages because of "fat overload." We reported 5 cases of HLH that occurred in patients with 4 different underlying disorders, all requiring TPN for a long term. In our series, an underlying immunological defect or a serious infection (sepsis) can have triggered HLH. Therefore, it could be reasonable to hypothesize that besides TPN in itself, minor immune defects and infections may act together by overcoming a threshold of immune stimulation, which ultimately leads to HLH.

}, keywords = {Child, Preschool, Fatty Acids, Female, Humans, Infant, Intestinal Diseases, Lymphohistiocytosis, Hemophagocytic, Male, Parenteral Nutrition, Total, Steroids, Treatment Outcome}, issn = {1536-3678}, doi = {10.1097/MPH.0b013e31829f381b}, author = {Pastore, Serena and Barbieri, Francesca and Di Leo, Grazia and Valencic, Erica and Tommasini, Alberto and Ventura, Alessandro} } @article {3521, title = {Intestinal-mucosa anti-transglutaminase antibody assays to test for genetic gluten intolerance.}, journal = {Cell Mol Immunol}, volume = {11}, year = {2014}, month = {2014 Nov}, pages = {617-20}, keywords = {Celiac Disease, Cell Surface Display Techniques, Child, Diet, Gluten-Free, Disease Progression, Early Diagnosis, Female, Follow-Up Studies, HLA-DQ Antigens, Humans, Immunoassay, Immunoglobulin A, Intestinal Mucosa, Male, Prospective Studies, Transglutaminases}, issn = {2042-0226}, doi = {10.1038/cmi.2014.32}, author = {Quaglia, Sara and De Leo, Luigina and Ziberna, Fabiana and Vatta, Serena and Villanacci, Vincenzo and Granzotto, Marilena and Petix, Vincenzo and Martelossi, Stefano and Di Leo, Grazia and Torelli, Lucio and Not, Tarcisio} } @article {1596, title = {Compliance with the gluten-free diet: the role of locus of control in celiac disease.}, journal = {J Pediatr}, volume = {158}, year = {2011}, month = {2011 Mar}, pages = {463-466.e5}, abstract = {

OBJECTIVES: To verify whether subjects with celiac disease (CD) have a different locus of control (LoC) compared with healthy subjects, and to evaluate the relationship between LoC and compliance with a prescribed gluten-free diet (GFD) and quality of life (QoL).

STUDY DESIGN: We studied 156 subjects on a GFD (mean age, 10 years) and 353 healthy controls (mean age, 12 years). All subjects completed tests on the Nowicki-Strickland Locus of Control Scale; the subjects with CD also completed a questionnaire to measure compliance with dietary treatment and the disease{\textquoteright}s impact on QoL.

RESULTS: There was no difference in LoC values between patients with CD and controls. Subjects with CD with good dietary compliance had a more internal LoC compared with those who were not compliant (P = .01). Patients who reported a satisfactory QoL had a more internal LoC compared with those who reported negative affects on QoL due to CD (P = .01).

CONCLUSIONS: Our study confirms the usefulness of the LoC concept for identifying those patients who might be at risk for dietary transgression. Given the enhanced, psychological, and social well being that can result from adherence to a GFD, educational and psychological support can help internalize the LoC in those patients at risk for dietary transgression.

}, keywords = {Adolescent, Age Factors, Case-Control Studies, Celiac Disease, Child, Diet, Gluten-Free, Female, Humans, Internal-External Control, Italy, Male, Patient Compliance, Quality of Life}, issn = {1097-6833}, doi = {10.1016/j.jpeds.2010.08.034}, author = {Bellini, Anna and Zanchi, Chiara and Martelossi, Stefano and Di Leo, Grazia and Not, Tarcisio and Ventura, Alessandro} } @article {1685, title = {Refractory iron-deficiency anaemia in a child with portal cavernoma.}, journal = {Gut}, volume = {60}, year = {2011}, month = {2011 Mar}, pages = {317, 377}, keywords = {Anemia, Iron-Deficiency, Antihypertensive Agents, Child, Hemangioma, Cavernous, Humans, Hypertension, Portal, Ileal Diseases, Male, Propranolol, Vascular Neoplasms}, issn = {1468-3288}, doi = {10.1136/gut.2009.184697}, author = {Pastore, Serena and Londero, Margherita and Cont, Gabriele and Di Leo, Grazia and Ventura, Alessandro} } @article {1763, title = {Two lumens, one diagnosis.}, journal = {J Pediatr}, volume = {159}, year = {2011}, month = {2011 Sep}, pages = {511}, keywords = {Capsule Endoscopy, Child, Preschool, Gastrointestinal Hemorrhage, Humans, Male, Meckel Diverticulum, Recurrence}, issn = {1097-6833}, doi = {10.1016/j.jpeds.2011.04.041}, author = {Pastore, Serena and Gortani, Giulia and Maschio, Massimo and Di Leo, Grazia and Ventura, Alessandro} }