Chronic inflammatory bowel disease in children: modern invasive and non-invasive diagnosis
Keywords:
chronic inflammatory bowel diseases, endoscopy, fecal and serological biomarkersAbstract
A review of the scientific literature on current methods of diagnosis of chronic inflammatory bowel disease (CIBD) in children was conducted. A broad search strategy has been applied using the following search term: «chronic inflammatory bowel disease», «diagnostics», «endoscopy», «biomarkers», «fecal markers», using as search engines PubMed and Embase. Abstracts of 123 articles and 56 full-text articles of the last 15 years have been analyzed.Diagnosis of CIBD causes some difficulties. The «golden standard» in the diagnostic algorithm remains the endoscopic methods, since they allow histological examination of biopsy samples. However, this invasive procedure, which usually requires patient sedation, causes discomfort and is relatively expensive. Other instrumental methods such as MRI and CT are relatively expensive, not always available and not always well tolerated by all patients. Fecal calprotectin and lactoferrin are the most proven biomarkers of intestinal inflammation. The role of cytokines performing pro- and anti-inflammatory functions is ongoing. From serological diagnostics, the biomarkers for the CIBD are ASCA and pANCA. In recent years, there have been other tokens that may appear to be better and provide additional information. These include other proteins, such as S100A12, M2-PK, polymorphonuclear elastase.
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