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Pediatric inflammatory bowel disease.

机译：小儿炎症性肠病。

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PURPOSE OF THIS REVIEW: The prevalence of early-onset inflammatory bowel disease has been on the rise, with children and adolescents currently accounting for approximately 30% of all patients with this condition. Remarkable new advances in diagnostic modalities and therapy for adults with inflammatory bowel disease, and further information about the role of genetics in determining susceptibility to disease make the review of the recent literature in pediatric inflammatory bowel disease more timely than ever. RECENT FINDINGS: In the area of genetics, new studies provide strong evidence for genetic susceptibility to disease, and match genotype with phenotypic presentation. A few studies examine the use of noninvasive diagnostic modalities, such as MRI, and biomarkers (fecal lactoferrin) in pediatric inflammatory bowel disease. Remarkable new agents in therapy for adults with inflammatory bowel disease have been empirically administered to children with inflammatory bowel disease. The first attempts to systematically study the effects of these agents in children and adolescents are reviewed here. Furthermore, new studies revise our notion of surgical outcomes in pediatric inflammatory bowel disease. SUMMARY: Although premature for clinical practice application, the role of genetic testing in determining disease susceptibility and assisting with prognosis and course of therapy is clearly evolving and needs further study. As new therapeutic agents join the available treatments of inflammatory bowel disease it is imperative to include pediatric patients in clinical trials. The goals of future studies will be to alter the natural history of early-onset inflammatory bowel disease, reduce the frequency of recurrences, and perhaps reduce requirements for surgical intervention.
机译：本综述的目的：早发性炎症性肠病的患病率呈上升趋势，儿童和青少年目前约占这种情况下所有患者的30％。成人炎症性肠病的诊断方法和治疗方面的显着新进展，以及有关遗传学在确定疾病易感性中的作用的进一步信息，使得对儿科炎症性肠病的最新文献的回顾比以往任何时候都更为及时。最近的发现：在遗传学领域，新的研究为遗传对疾病的易感性提供了有力的证据，并使基因型与表型匹配。少数研究检查了小儿炎症性肠病中无创诊断方法（如MRI）和生物标志物（粪便乳铁蛋白）的使用。已经根据经验向患有炎症性肠病的儿童施用了治疗成人炎症性肠病的显着新药。本文综述了系统研究这些药物对儿童和青少年的影响的首次尝试。此外，新的研究修订了我们在小儿炎症性肠病中手术结局的概念。简介：尽管在临床实践中应用尚为时过早，但是基因检测在确定疾病易感性以及辅助预后和治疗过程方面的作用显然正在发展，需要进一步研究。随着新的治疗剂加入炎症性肠病的可用治疗方法，必须将儿科患者纳入临床试验。未来研究的目标是改变早发性炎症性肠病的自然史，减少复发频率，并可能减少手术干预的需求。

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