JLE

Médecine thérapeutique / Pédiatrie

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Diagnostic strategy for suspicion of pediatric inflammatory bowel disease Volume 14, issue 3, Mai-Juin 2011

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Author
CHU de Limoges, Hôpital mère-enfant, Département de pédiatrie médicale, 8, avenue Dominique Larrey, 87042 Limoges, France

Nearly a quarter of inflammatory bowel diseases (IBD) are revealed during paediatric age through insidious and vaguely specific symptoms. Early diagnosis can allow for fast medical and nutritional treatment, avoiding heavy repercussions on staturo-ponderal growth and puberty development. Suspicion of IBD must lead to a rigorous clinical, anamnestic and anthropometric approach with simple biological explorations looking for inflammation. In atypical cases, biological markers of orientation will be possibly supplemented with examination for echographic intestinal inflammation or by faecal calprotectin determination to assess mucosal inflammation. Diagnostic strategy of specialized teams depends on local expertise and possibilities of access to new techniques of imagery, but always include a high and low endoscopic digestive exploration with multiple and staged biopsies, and research for small bowel and extradigestive manifestations.