Chronic colitis in children. Problems of differential diagnosis

Authors

  • O.G. Shadrin SI «Institute of Pediatrics, Obstetrics and Gynecology named after academician O.M. Lukyanova of the NAMS of Ukraine», Kyiv, Ukraine https://orcid.org/0000-0002-5901-7013
  • M.H. Horіanska SI «Institute of Pediatrics, Obstetrics and Gynecology named after academician O.M. Lukyanova of the NAMS of Ukraine», Kyiv, Ukraine https://orcid.org/0000-0002-1820-8972
  • T.M. Archakova SI «Institute of Pediatrics, Obstetrics and Gynecology named after academician O.M. Lukyanova of the NAMS of Ukraine», Kyiv, Ukraine
  • R.V. Mostovenko National Children’s Specialized Hospital «OKHMATDYT», Kyiv, Ukraine
  • V.V. Zayets SI «Institute of Pediatrics, Obstetrics and Gynecology named after academician O.M. Lukyanova of the NAMS of Ukraine», Kyiv, Ukraine

DOI:

https://doi.org/10.15574/SP.2024.137.132

Keywords:

children, inflammatory bowel diseases, collagenous colitis, collagenous gastritis, diagnosis, treatment

Abstract

During the last few decades, there has been observed a "rejuvenation" of the inflammatory bowel diseases (IBD) onset in childhood. Very often the problem is narrowed down to the differential diagnosis of Crohn's disease and ulcerative colitis, which are related to IBD, although in reality the spectrum of chronic IBD is much wider. A diagnosed case of microscopic (collagenous) colitis confirms the need for a wide diagnostic search in patients with IBD.

Purpose - to describe differential diagnostic features of collagenous colitis and collagenous gastritis in young children.

Clinical case. Observational data on a patient aged 1 year and 7 months with a special form of colitis (collagenous colitis in combination with collagenous gastritis) are presented. The peculiarities of this rare disease course in the examined patient, in whom the pathology debuted with gastric ulcers with hematemesis, anemia and diarrhea syndrome, were analyzed. The differential search complex stages are discussed in detail, the results of laboratory, instrumental and pathomorphological research methods are described. Information is provided on the treatment prospects of patients with a gastrointestinal tract collagenous pathological process. There is a justified need to take into account rare causes of digestive tract inflammation when observing young patients with a clinical picture similar to the IBD debut.

The research was carried out in accordance with the principles of the Declaration of Helsinki. The informed consent of the child's parents was obtained for conducting the studies.

No conflict of interests was declared by the authors.

References

Benchimol EI, Mack DR, Nguyen GC et al. (2014). Incidence, outcomes, and health services burden of very early onset inflammatory bowel disease. Gastroenterology. 147(4): 803-813. https://doi.org/10.1053/j.gastro.2014.06.023; PMid:24951840

Bequet E, Sarter H, Fumery M, Vasseur F et al. (2017). Incidence and Phenotype at Diagnosis of Very-early-onset Compared with Later-onset Paediatric Inflammatory Bowel Disease: A Population-based Study [1988-2011]. J Crohns Colitis. 11(5): 519-526.

Capriati T, Cardile S, Papadatou B, Romano C, Knafelz D, Bracci F, Diamanti A. (2016). Pediatric inflammatory bowel disease: specificity of very early onset. Expert Rev Clin Immunol. 12(9): 963-972. https://doi.org/10.1080/1744666X.2016.1184571; PMid:27247160

Genta RM, Turner KO, Morgan CJ, Sonnenberg A. (2021). Collagenous gastritis: Epidemiology and clinical associations. Dig Liver Dis. 53(9):1136-1140. https://doi.org/10.1016/j.dld.2021.03.010; PMid:33824091

Käppi T, Wanders A, Wolving M, Lingblom C, Davidsson Bården B, Arkel R et al. (2020). Collagenous Gastritis in Children: Incidence, Disease Course, and Associations With Autoimmunity and Inflammatory Markers. Clin Transl Gastroenterol. 11(8): e00219. https://doi.org/10.14309/ctg.0000000000000219; PMid:32955189 PMCid:PMC7431242

Kelsen JR, Sullivan KE, Rabizadeh S, Singh N, Snapper S, Elkadri A, Grossman AB. (2020). North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition Position Paper on the Evaluation and Management for Patients With Very Early-onset Inflammatory Bowel Disease. J Pediatr Gastroenterol Nutr. 70(3): 389-403. https://doi.org/10.1097/MPG.0000000000002567; PMid:32079889

Levine A, Griffiths A, Markowitz J, Wilson DC, Turner D, Russell RK et al. (2011). Pediatric modification of the Montreal classification for inflammatory bowel disease: the Paris classification. Inflamm Bowel Dis. 17(6): 1314-1321. https://doi.org/10.1002/ibd.21493; PMid:21560194

Liu X, Xiao SY, Plesec TP, Jiang W, Goldblum JR, Lazenby AJ. (2013). Collagenous colitis in children and adolescent: study of 7 cases and literature review. Modern Pathology. 26(6): 881-887. https://doi.org/10.1038/modpathol.2012.227; PMid:23348901

Ma C, Park JY, Montgomery EA et al. (2015). A comparative clinicopathologic study of collagenous gastritis in children and adults. Am J Surg Pathol. 39(6): 802-812. https://doi.org/10.1097/PAS.0000000000000441; PMid:25871617

Miehlke S, Guagnozzi D, Zabana Y et al. (2021). European guidelines on microscopic colitis: United European Gastroenterology and European Microscopic Colitis Group statements and recommendations. United European Gastroenterol J. 9(1): 13-37. https://doi.org/10.1177/2050640620951905; PMid:33619914 PMCid:PMC8259259

Montero JI, Viala J, Rebeuh J, Berthet S, Blais R, Caldari D et al. (2023). Collagenous gastritis in children: A national cohort. Arch Pediatr. 30(5): 307-313. https://doi.org/10.1016/j.arcped.2023.03.013; PMid:37236887

Muise AA. (2019). Very Early Onset Inflammatory Bowel Disease. Textbook of Autoinflammation. Springer International Publishing: 383-404. https://doi.org/10.1007/978-3-319-98605-0_21

Sýkora J, Pomahačová R, Kreslová M, Cvalínová D, Štych P, Schwarz J. (2018). Current global trends in the incidence of pediatric-onset inflammatory bowel disease. World J Gastroenterol. 24(25): 2741-2763. https://doi.org/10.3748/wjg.v24.i25.2741; PMid:29991879 PMCid:PMC6034144

Uhlig HH, Charbit-Henrion F, Kotlarz D et al. (2021). Clinical Genomics for the Diagnosis of Monogenic Forms of Inflammatory Bowel Disease: A Position Paper From the Paediatric IBD Porto Group of European Society of Paediatric Gastroenterology, Hepatology and Nutrition. J Pediatr Gastroenterol Nutr. 72(3): 456-473. https://doi.org/10.1097/MPG.0000000000003017; PMid:33346580 PMCid:PMC8221730

Windon AL, Almazan E, Oliva-Hemker M, Hutchings D, Assarzadegan N, Salimian K et al. (2020). Lymphocytic and collagenous colitis in children and adolescents: Comprehensive clinicopathologic analysis with long-term follow-up. Hum Pathol. 106: 13-22. https://doi.org/10.1016/j.humpath.2020.09.011; PMid:32991931

Yuan L, Wu TT, Zhang L. (2023). Microscopic colitis: lymphocytic colitis, collagenous colitis, and beyond. Hum Pathol. 132: 89-101. https://doi.org/10.1016/j.humpath.2022.06.027; PMid:35809686

Published

2024-02-28