TY - JOUR T1 - Causes of Treatment Failure in Children With Inflammatory Bowel Disease Treated With Infliximab: A Pharmacokinetic Study. JF - J Pediatr Gastroenterol Nutr Y1 - 2019 A1 - Naviglio, Samuele A1 - Lacorte, Doriana A1 - Lucafò, Marianna A1 - Cifù, Adriana A1 - Favretto, Diego A1 - Cuzzoni, Eva A1 - Silvestri, Tania A1 - Pozzi Mucelli, Martina A1 - Radillo, Oriano A1 - Decorti, Giuliana A1 - Fabris, Martina A1 - Bramuzzo, Matteo A1 - Taddio, Andrea A1 - Stocco, Gabriele A1 - Alvisi, Patrizia A1 - Ventura, Alessandro A1 - Martelossi, Stefano AB -

OBJECTIVES: Anti-tumor necrosis factor antibodies have led to a revolution in the treatment of inflammatory bowel diseases (IBD); however, a sizable proportion of patients does not respond to therapy. There is increasing evidence suggesting that treatment failure may be classified as mechanistic (pharmacodynamic), pharmacokinetic, or immune-mediated. Data regarding the contribution of these factors in children with IBD treated with infliximab (IFX) are still incomplete. The aim was to assess the causes of treatment failure in a prospective cohort of pediatric patients treated with IFX.

METHODS: This observational study considered 49 pediatric (median age 14.4) IBD patients (34 Crohn disease, 15 ulcerative colitis) treated with IFX. Serum samples were collected at 6, 14, 22 and 54 weeks, before IFX infusions. IFX and anti-infliximab antibodies (AIA) were measured using enzyme linked immunosorbent assays. Disease activity was determined by Pediatric Crohn's Disease Activity Index or Pediatric Ulcerative Colitis Activity Index.

RESULTS: Clinical remission, defined as a clinical score <10, was obtained by 76.3% of patients at week 14 and by 73.9% at week 54. Median trough IFX concentration was higher at all time points in patients achieving sustained clinical remission. IFX levels during maintenance correlated also with C-reactive protein, albumin, and fecal calprotectin. After multivariate analysis, IFX concentration at week 14 >3.11 μg/mL emerged as the strongest predictor of sustained clinical remission. AIA concentrations were correlated inversely with IFX concentrations and directly with adverse reactions.

CONCLUSIONS: Most cases of therapeutic failure were associated with low serum drug levels. IFX trough levels at the end of induction are associated with sustained long-term response.

VL - 68 IS - 1 U1 - http://www.ncbi.nlm.nih.gov/pubmed/30211845?dopt=Abstract ER - TY - JOUR T1 - Efficacy and Safety of Adalimumab in Pediatric Ulcerative Colitis: A Real-life Experience from the SIGENP-IBD Registry. JF - J Pediatr Gastroenterol Nutr Y1 - 2018 A1 - Aloi, Marina A1 - Bramuzzo, Matteo A1 - Arrigo, Serena A1 - Romano, Claudio A1 - D'Arcangelo, Giulia A1 - Lacorte, Doriana A1 - Gatti, Simona A1 - Illiceto, Maria T A1 - Zucconi, Francesca A1 - Dilillo, Dario A1 - Zuin, Giovanna A1 - Knafelz, Daniela A1 - Ravelli, Alberto A1 - Cucchiara, Salvatore A1 - Alvisi, Patrizia AB -

OBJECTIVES: The aim of this study was to evaluate the effectiveness and safety of adalimumab (ADA) in children with ulcerative colitis (UC) previously treated with infliximab (IFX).

METHODS: Retrospective study including children with UC from a national registry who received ADA therapy. The primary endpoint was the rate of corticosteroid-free remission at week 52. Secondary outcomes were the rate of sustained clinical remission, primary nonresponse, and loss of response at weeks 12, 30, and 52 and rate of mucosal healing and side effects at week 52.

RESULTS: Thirty-two children received ADA (median age 10 ± 4 years). Median disease duration before ADA therapy was 27 months. All patients received previous IFX (43% intolerant, 50% nonresponders [37.5% primary, 42.5% secondary nonresponders], 6.7% positive anti-IFX antibodies). Fifty-two weeks after ADA initiation, 13 patients (41%) were in corticosteroid-free remission. Mucosal healing occurred in 9 patients (28%) at 52 weeks. The cumulative probability of a clinical relapse-free course was 69%, 59%, and 53% at 12, 30, and 52 weeks, respectively. Ten patients (31%) had a primary failure and 5 (15%) a loss of response to ADA. No significant differences in efficacy were reported between not-responders and intolerant to IFX (P = 1.0). Overall, 19 patient (59%) maintained ADA during 52-week follow-up. Seven patients (22%) experienced an adverse event, no serious side effects were observed and none resulted in ADA discontinuation.

CONCLUSIONS: Based on our data, ADA seems to be effective in children with UC, allowing to recover a significant percentage of patients intolerant or not-responding to IFX. The safety profile was good.

VL - 66 IS - 6 U1 - http://www.ncbi.nlm.nih.gov/pubmed/29315163?dopt=Abstract ER - TY - JOUR T1 - Fecal Calprotectin to Detect Inflammatory Bowel Disease in Juvenile Idiopathic Arthritis. JF - J Rheumatol Y1 - 2018 A1 - Ferrara, Giovanna A1 - Pastore, Serena A1 - Sancin, Lara A1 - Torelli, Lucio A1 - Radillo, Oriano A1 - Bramuzzo, Matteo A1 - Bibalo, Chiara A1 - Tommasini, Alberto A1 - Ventura, Alessandro A1 - Taddio, Andrea AB -

OBJECTIVE: This study aimed to test fecal calprotectin (FC) as a screening tool to identify inflammatory bowel disease (IBD) among patients with juvenile idiopathic arthritis (JIA).

METHODS: FC level < 100 g/kg was considered normal. Patients with 2 consecutive FC dosage ≥ 100 g/kg underwent endoscopic evaluation.

RESULTS: There were 113 patients with JIA enrolled. FC was raised in 7 patients out of 113. All patients had IBD. In 3/7 patients, high FC levels were the only sign consistent with IBD.

CONCLUSION: FC is a useful, economical, and noninvasive diagnostic tool to identify JIA patients with underlying IBD.

VL - 45 IS - 10 U1 - http://www.ncbi.nlm.nih.gov/pubmed/29907671?dopt=Abstract ER - TY - JOUR T1 - High-Throughput Sequencing of microRNAs in Glucocorticoid Sensitive Paediatric Inflammatory Bowel Disease Patients. JF - Int J Mol Sci Y1 - 2018 A1 - De Iudicibus, Sara A1 - Lucafò, Marianna A1 - Vitulo, Nicola A1 - Martelossi, Stefano A1 - Zimbello, Rosanna A1 - De Pascale, Fabio A1 - Forcato, Claudio A1 - Naviglio, Samuele A1 - Di Silvestre, Alessia A1 - Gerdol, Marco A1 - Stocco, Gabriele A1 - Valle, Giorgio A1 - Ventura, Alessandro A1 - Bramuzzo, Matteo A1 - Decorti, Giuliana KW - Adolescent KW - Biomarkers KW - Child KW - Female KW - Gene Expression Regulation KW - Glucocorticoids KW - High-Throughput Nucleotide Sequencing KW - Humans KW - Inflammatory Bowel Diseases KW - Male KW - MicroRNAs KW - Receptors, Glucocorticoid KW - Transcriptome AB -

The aim of this research was the identification of novel pharmacogenomic biomarkers for better understanding the complex gene regulation mechanisms underpinning glucocorticoid (GC) action in paediatric inflammatory bowel disease (IBD). This goal was achieved by evaluating high-throughput microRNA (miRNA) profiles during GC treatment, integrated with the assessment of expression changes in GC receptor (GR) heterocomplex genes. Furthermore, we tested the hypothesis that differentially expressed miRNAs could be directly regulated by GCs through investigating the presence of GC responsive elements (GREs) in their gene promoters. Ten IBD paediatric patients responding to GCs were enrolled. Peripheral blood was obtained at diagnosis (T0) and after four weeks of steroid treatment (T4). MicroRNA profiles were analyzed using next generation sequencing, and selected significantly differentially expressed miRNAs were validated by quantitative reverse transcription-polymerase chain reaction. In detail, 18 miRNAs were differentially expressed from T0 to T4, 16 of which were upregulated and 2 of which were downregulated. Out of these, three miRNAs (miR-144, miR-142, and miR-96) could putatively recognize the 3’UTR of the GR gene and three miRNAs (miR-363, miR-96, miR-142) contained GREs sequences, thereby potentially enabling direct regulation by the GR. In conclusion, we identified miRNAs differently expressed during GC treatment and miRNAs which could be directly regulated by GCs in blood cells of young IBD patients. These results could represent a first step towards their translation as pharmacogenomic biomarkers.

VL - 19 IS - 5 U1 - http://www.ncbi.nlm.nih.gov/pubmed/29738455?dopt=Abstract ER - TY - JOUR T1 - Immunohistologic analysis of the duodenal bulb: a new method for celiac disease diagnosis in children. JF - Gastrointest Endosc Y1 - 2018 A1 - De Leo, Luigina A1 - Villanacci, Vincenzo A1 - Ziberna, Fabiana A1 - Vatta, Serena A1 - Martelossi, Stefano A1 - Di Leo, Grazia A1 - Zanchi, Chiara A1 - Bramuzzo, Matteo A1 - Giudici, Fabiola A1 - Ventura, Alessandro A1 - Not, Tarcisio KW - Adolescent KW - Autoantibodies KW - Celiac Disease KW - Child KW - Child, Preschool KW - Duodenum KW - Female KW - Humans KW - Immunoglobulin A KW - Immunohistochemistry KW - Infant KW - Male KW - Prospective Studies KW - Transglutaminases AB -

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 ± 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 ± 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 ± 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.

VL - 88 IS - 3 U1 - http://www.ncbi.nlm.nih.gov/pubmed/29807020?dopt=Abstract ER - TY - JOUR T1 - Curcumin Anti-Apoptotic Action in a Model of Intestinal Epithelial Inflammatory Damage. JF - Nutrients Y1 - 2017 A1 - Loganes, Claudia A1 - Lega, Sara A1 - Bramuzzo, Matteo A1 - Vecchi Brumatti, Liza A1 - Piscianz, Elisa A1 - Valencic, Erica A1 - Tommasini, Alberto A1 - Marcuzzi, Annalisa KW - Anti-Inflammatory Agents, Non-Steroidal KW - Apoptosis KW - Cell Survival KW - Curcuma KW - Curcumin KW - Cytokines KW - Epithelial Cells KW - HT29 Cells KW - Humans KW - Inflammation KW - Interferon-gamma KW - Interleukin-7 KW - Intestinal Mucosa KW - NF-kappa B KW - Phosphorylation KW - Signal Transduction AB -

The purpose of this study is to determine if a preventive treatment with curcumin can protect intestinal epithelial cells from inflammatory damage induced by IFNγ. To achieve this goal we have used a human intestinal epithelial cell line (HT29) treated with IFNγ to undergo apoptotic changes that can reproduce the damage of intestinal epithelia exposed to inflammatory cytokines. In this model, we measured the effect of curcumin (curcuminoid from ) added as a pre-treatment at different time intervals before stimulation with IFNγ. Curcumin administration to HT29 culture before the inflammatory stimulus IFNγ reduced the cell apoptosis rate. This effect gradually declined with the reduction of the curcumin pre-incubation time. This anti-apoptotic action by curcumin pre-treatment was paralleled by a reduction of secreted IL7 in the HT29 culture media, while there was no relevant change in the other cytokine levels. Even though curcumin pre-administration did not impact the activation of the NF-κB pathway, a slight effect on the phosphorylation of proteins in this inflammatory signaling pathway was observed. In conclusion, curcumin pre-treatment can protect intestinal cells from inflammatory damage. These results can be the basis for studying the preventive role of curcumin in inflammatory bowel diseases.

VL - 9 IS - 6 U1 - http://www.ncbi.nlm.nih.gov/pubmed/28587282?dopt=Abstract ER - TY - JOUR T1 - Effect of Early Versus Late Azathioprine Therapy in Pediatric Ulcerative Colitis. JF - Inflamm Bowel Dis Y1 - 2016 A1 - Aloi, Marina A1 - DʼArcangelo, Giulia A1 - Bramuzzo, Matteo A1 - Gasparetto, Marco A1 - Martinelli, Massimo A1 - Alvisi, Patrizia A1 - Illiceto, Maria Teresa A1 - Valenti, Simona A1 - Distante, Manuela A1 - Pellegrino, Salvatore A1 - Gatti, Simona A1 - Arrigo, Serena A1 - Civitelli, Fortunata A1 - Martelossi, Stefano AB -

BACKGROUND: We aimed at describing the efficacy of azathioprine (AZA) in pediatric ulcerative colitis, comparing the outcomes of early (0-6 months) versus late (6-24 months) initiation of therapy.

METHODS: Children with ulcerative colitis treated with AZA within 24 months of diagnosis were included. Corticosteroid (CS)-free remission and mucosal healing (MH), assessed by endoscopy or fecal calprotectin, at 12 months were the primary outcomes. Patients were also compared for CS-free remission and MH, need for treatment escalation or surgery, number of hospitalizations, and adverse events during a 24-month follow-up.

RESULTS: A total of 121 children entered the study (median age 10.5 ± 4.0 years, 59% girls). Seventy-six (63%) started AZA between 0 and 6 months (early group) and 45 (37%) started between 6 and 24 months (late group). Seventy-five percent and 53% of patients in the early and late group, respectively, received CS at the diagnosis (P = 0.01). CS-free remission at 1 year was achieved by 30 (50%) of the early and 23 (57%) of the late patients (P = 0.54). MH occurred in 37 (37%) patients at 1 year, with no difference between the 2 groups (33% early, 42% late; P = 0.56). No difference was found for the other outcomes.

CONCLUSIONS: Introduction of AZA within 6 months of diagnosis seems not more effective than later treatment to achieve CS-free remission in pediatric ulcerative colitis. MH does not depend on the timing of AZA initiation; however, because of the incomplete comparability of the 2 groups at the diagnosis and the use of fecal calprotectin as a surrogate marker of MH, our results should be further confirmed by prospective studies.

VL - 22 IS - 7 U1 - http://www.ncbi.nlm.nih.gov/pubmed/27271489?dopt=Abstract ER - TY - JOUR T1 - The Great Pretender: Pediatric Wandering Spleen: Two Case Reports and Review of the Literature. JF - Pediatr Emerg Care Y1 - 2016 A1 - Radillo, Lucia A1 - Taddio, Andrea A1 - Ghirardo, Sergio A1 - Bramuzzo, Matteo A1 - Pederiva, Federica A1 - Maschio, Massimo A1 - Barbi, Egidio AB -

Wandering spleen is a rare condition, typically not only due to embryological defects of the splenic ligaments, but also secondary to trauma and splenomegaly. The most common presentation is acute abdomen with a mobile abdominal mass or recurrent abdominal pain. However, the spleen may be temporary in its normal position, and patients could be asymptomatic. A familiarity, if present, strengthens the diagnostic suspect.Abdominal ultrasonography and computed tomography are the examination of choice, and the management is surgical.

U1 - http://www.ncbi.nlm.nih.gov/pubmed/27248774?dopt=Abstract ER - TY - JOUR T1 - Thalidomide for inflammatory bowel disease: Systematic review. JF - Medicine (Baltimore) Y1 - 2016 A1 - Bramuzzo, Matteo A1 - Ventura, Alessandro A1 - Martelossi, Stefano A1 - Lazzerini, Marzia AB -

BACKGROUND: Thalidomide is an immunomodulatory drug used in the experimental treatment of refractory Crohn disease and ulcerative colitis. We aimed to review the existing evidence on the efficacy and safety of thalidomide in the treatment of inflammatory bowel diseases.

METHODS: CENTRAL, MEDLINE, LILACS, POPLINE, CINHAL, and Web of Science were searched in March 2016. Manual search included conference and reference lists. All types of studies, except single case reports, were included. Outcomes evaluated were: induction of remission; maintenance of remission; steroid reduction; effect on penetrating Crohn disease; endoscopic remission; adverse events.

RESULTS: The research strategies retrieved 722 papers. Two randomized controlled trials and 29 uncontrolled studies for a total of 489 patients matched the inclusion criteria. Thalidomide induced a clinical response in 296/427 (69.3%) patients. Clinical remission was achieved in 220/427 (51.5%) cases. Maintenance of remission was reported in 128/160 (80.0%) patients at 6 months and in 96/133 (72.2%) at 12 months. Reduction in steroid dosage was reported in 109/152 (71.7%) patients. Fistulas improved in 49/81 (60.5%) cases and closed in 28/81 (34.6%). Endoscopic improvement was observed in 46/66 (69.7%) and complete mucosal healing in 35/66 (53.0%) patients. Cumulative incidence of total adverse events and of those leading to drug suspension was 75.6 and 19.7/1000 patient-months, respectively. Neurological disturbances accounted for 341/530 (64.3%) adverse events and were the most frequent cause of drug withdrawal.

CONCLUSION: Existing evidence suggests that thalidomide may be a valid treatment option for patients with inflammatory bowel diseases refractory to other first- and second-line treatments.

VL - 95 IS - 30 U1 - http://www.ncbi.nlm.nih.gov/pubmed/27472695?dopt=Abstract ER - TY - JOUR T1 - Torticollis as the Presenting Sign of Cervical Spondylodiscitis. JF - Pediatr Emerg Care Y1 - 2016 A1 - Pizzol, Antonio A1 - Bramuzzo, Matteo A1 - Pillon, Roberto A1 - Taddio, Andrea A1 - Barbi, Egidio AB -

Acquired torticollis is a common clinical finding in children evaluated in the pediatric emergency department. It may be the presentation symptom of different illnesses, such as trauma, muscle contraction, infections, or malignancies, and an accurate differential diagnosis is required to correctly identify the cause and choose the right treatment. Spondylodiscitis is a low-grade bacterial infection that involves intervertebral disks and the adjacent vertebral bodies. Spondylodiscitis of the cervical spine is unusual and may be a rare cause of torticollis. We report the case of a 4-year-old male patient admitted to the emergency department for a 5-day history of painful torticollis. Blood tests showed an elevated erythrocyte sedimentation rate. The radiograph of the cervical spine showed a thin fifth cervical soma. The magnetic resonance imaging of cervical spine showed the alteration of cervical vertebral bodies and intervertebral disks, suggesting the diagnosis of cervical spondylodiscitis. The patient recovered after endovenous antibiotic treatment. We suggest that cervical spondylodiscitis should be suspected and investigated by means of an magnetic resonance imaging in every case of unexplained torticollis with persisting symptoms.

U1 - http://www.ncbi.nlm.nih.gov/pubmed/27248775?dopt=Abstract ER - TY - JOUR T1 - Effect of Thalidomide on Clinical Remission in Children and Adolescents with Ulcerative Colitis Refractory to Other Immunosuppressives: Pilot Randomized Clinical Trial. JF - Inflamm Bowel Dis Y1 - 2015 A1 - Lazzerini, Marzia A1 - Martelossi, Stefano A1 - Magazzù, Giuseppe A1 - Pellegrino, Salvatore A1 - Lucanto, Maria Cristina A1 - Barabino, Arrigo A1 - Calvi, Angela A1 - Arrigo, Serena A1 - Lionetti, Paolo A1 - Lorusso, Monica A1 - Mangiantini, Francesca A1 - Fontana, Massimo A1 - Zuin, Giovanna A1 - Palla, Gabriella A1 - Maggiore, Giuseppe A1 - Bramuzzo, Matteo A1 - Pellegrin, Maria Chiara A1 - Maschio, Massimo A1 - Villanacci, Vincenzo A1 - Manenti, Stefania A1 - Decorti, Giuliana A1 - De Iudicibus, Sara A1 - Paparazzo, Rossella A1 - Montico, Marcella A1 - Ventura, Alessandro AB -

BACKGROUND: In a randomized controlled trial, thalidomide has shown to be effective in refractory Crohn's disease in children. This pilot study aimed at evaluating thalidomide in refractory pediatric ulcerative colitis (UC).

METHODS: Double-blind, placebo-controlled randomized clinical trial on thalidomide 1.5 to 2.5 mg/kg/day in children with active UC despite multiple immunosuppressive treatments. In an open-label extension, nonresponders to placebo received thalidomide for an additional 8 weeks; all responders were followed up for a minimum of 52 weeks.

RESULTS: Twenty-six children with refractory UC were randomized to thalidomide or placebo. Clinical remission at week 8 was achieved by significantly more children treated with thalidomide {10/12 (83.3%) versus 2/11 (18.8%); risk ratio, 4.5 (95% confidence interval [CI], 1.2-16.4); P = 0.005; number needed to treat, 1.5}. Of the nonresponders to placebo who were switched to thalidomide, 8 of 11 (72.7%) subsequently reached remission at week 8 (risk ratio, 4.0 [95% CI, 1.1-14.7]; number needed to treat, 2.45; P = 0.01). Clinical remission in the thalidomide group was 135.0 weeks (95% CI, 32-238), compared with 8.0 weeks (95% CI, 2.4-13.6) in the placebo group (P < 0.0001). Cumulative incidence of severe adverse events was 3.1 per 1000 patient-weeks. Peripheral neuropathy and amenorrhea were the most frequent adverse events.

CONCLUSIONS: In this pilot randomized controlled trial on cases of UC refractory to immunosuppressive therapy, thalidomide compared with placebo resulted in improved clinical remission at 8 weeks of treatment and in longer term maintenance of remission. These findings require replication in larger clinical studies evaluating both thalidomide efficacy and safety.

VL - 21 IS - 8 U1 - http://www.ncbi.nlm.nih.gov/pubmed/26185909?dopt=Abstract ER - TY - JOUR T1 - Association between orofacial granulomatosis and Crohn's disease in children: systematic review. JF - World J Gastroenterol Y1 - 2014 A1 - Lazzerini, Marzia A1 - Bramuzzo, Matteo A1 - Ventura, Alessandro KW - Adolescent KW - Age of Onset KW - Child KW - Child, Preschool KW - Crohn Disease KW - Female KW - Granulomatosis, Orofacial KW - Humans KW - Immunosuppressive Agents KW - Male KW - Prevalence KW - Risk Factors KW - Steroids KW - Treatment Outcome AB -

AIM: To review pediatric cases of orofacial granulomatosis (OFG), report disease characteristics, and explore the association between OFG and Crohn's disease.

METHODS: We conducted a systematic review according to the PRISMA guidelines. We searched Medline, LILACS, Virtual Health Library, and Web of Knowledge in September 2013 for cases of OFG in the pediatric age range (< 18 years), with no language limitations. All relevant articles were accessed in full text. The manual search included references of retrieved articles. We extracted data on patients' characteristics, disease characteristics, association with other diseases, and treatment. We analyzed the data and reported the results in tables and text.

RESULTS: We retrieved 173 reports of OFG in children. Mean age at onset was 11.1 ± 3.8 years (range: 2.0-18 years). Prevalence in males was significant higher than in females (P < 0.001), with a male:female ratio of 2:1. Gastrointestinal signs or symptoms were present in 26.0% of children at the time of OFG diagnosis. Overall, 70/173 (40.4%) children received a concomitant diagnosis of Crohn's disease. In about half (51.4%) of the cases the onset of OFG anticipated the diagnosis of Crohn's disease, with a mean time between the two diagnoses of 13.1 ± 11.6 mo (range: 3-36 mo). Overall, 21/173 (12.1%) of the children with OFG had perianal disease, while 11/173 (6.4%) had a family history of Crohn's disease. Both perianal disease and a family history of Crohn's disease were significantly associated with a higher risk of Crohn's disease diagnosis in children with OFG [relative risk (RR) = 3.10, 95% confidence interval (CI): 2.46-3.90; RR = 2.74, 95%CI: 2.24-3.36, P < 0.0001 for both). Treatment of OFG included steroids (70.8% of children) and other immunosuppressive drugs (42.7%), such as azathioprine, thalidomide and infliximab.

CONCLUSION: High prevalence of Crohn's disease in children with OFG suggests that OFG may be a subtype of Crohn's disease.

VL - 20 IS - 23 U1 - http://www.ncbi.nlm.nih.gov/pubmed/24966621?dopt=Abstract ER - TY - JOUR T1 - Multiple Ileo-Ileal Intussusceptions Caused by Eosinophilic Enteropathy. JF - J Pediatr Gastroenterol Nutr Y1 - 2014 A1 - Bramuzzo, Matteo A1 - Martelossi, Stefano A1 - Villanacci, Vincenzo A1 - Maschio, Massimo A1 - Costa, Stefano A1 - Ventura, Alessandro U1 - http://www.ncbi.nlm.nih.gov/pubmed/25000350?dopt=Abstract ER - TY - JOUR T1 - Amenorrhea in women treated with thalidomide: report of two cases and literature review. JF - Inflamm Bowel Dis Y1 - 2013 A1 - Lazzerini, Marzia A1 - Bramuzzo, Matteo A1 - Martelossi, Stefano A1 - Magazzù, Giuseppe A1 - Pellegrino, Salvatore A1 - Ventura, Alessandro KW - Adolescent KW - Amenorrhea KW - Colitis, Ulcerative KW - Crohn Disease KW - Female KW - Humans KW - Review Literature as Topic KW - Thalidomide VL - 19 IS - 1 U1 - http://www.ncbi.nlm.nih.gov/pubmed/22161965?dopt=Abstract ER - TY - JOUR T1 - Prevalence of anaemia in children with thromboembolism in IBD. JF - Arch Dis Child Y1 - 2011 A1 - Bramuzzo, Matteo A1 - Lazzerini, Marzia KW - Anemia, Iron-Deficiency KW - Female KW - Humans KW - Male KW - Stroke VL - 96 IS - 8 U1 - http://www.ncbi.nlm.nih.gov/pubmed/21377991?dopt=Abstract ER - TY - JOUR T1 - Thromboembolism in pediatric inflammatory bowel disease: systematic review. JF - Inflamm Bowel Dis Y1 - 2011 A1 - Lazzerini, Marzia A1 - Bramuzzo, Matteo A1 - Maschio, Massimo A1 - Martelossi, Stefano A1 - Ventura, Alessandro KW - Adult KW - Child KW - Humans KW - Inflammatory Bowel Diseases KW - Risk Factors KW - Thromboembolism AB -

BACKGROUND: Several studies suggest an increased risk of venous and arterial thromboembolism (TE) in adults with inflammatory bowel disease (IBD) compared to the general population. We performed a systematic review of studies on incidence and characteristic of TE in children with IBD.

METHODS: We searched Medline, LILACS, EMBASE, POPLINE, CINHAL, and reference lists of identified articles, without language restrictions, in August 2010.

RESULTS: Population studies suggest that there is an increased risk of TE in children with IBD compared to controls. TE occurred in children with IBD in all age ranges, mostly (82.8%) during active disease, and more frequently in children with ulcerative colitis (odds ratio [OR] 3.7, 95% confidence interval [CI] 1.8-7.6). At least one specific risk factor for TE was recognized in 50% of cases; two risk factors were present in 24%. Out of 92 published cases of TE in children with IBD, 54.3% occurred in cerebral site, 26% in the limbs, 13% in the abdominal vessels, and the remaining in the retina and lungs. After a first episode of TE, an early recurrence was observed in 11.4% of children, a late recurrence in 10%. A number of different therapeutic schemes were used. Overall mortality was 5.7% and was mostly associated with cerebral TE.

CONCLUSIONS: Population studies are needed to clarify the risk of TE in children with IBD, the relative weight of other risk factors, the characteristics of the events, and to define guidelines of therapy and prophylaxis.

VL - 17 IS - 10 U1 - http://www.ncbi.nlm.nih.gov/pubmed/21910180?dopt=Abstract ER - TY - JOUR T1 - Neonatal jaundice and breastfeeding reputation. JF - J Hum Lact Y1 - 2010 A1 - Bramuzzo, Matteo A1 - Davanzo, Riccardo KW - Bottle Feeding KW - Breast Feeding KW - Female KW - Humans KW - Infant, Newborn KW - Jaundice, Neonatal KW - Lactation Disorders KW - Milk, Human KW - Risk Factors VL - 26 IS - 4 U1 - http://www.ncbi.nlm.nih.gov/pubmed/21047987?dopt=Abstract ER -