B. Papadatou

Response to infliximab is related to disease duration in paediatric Crohn's disease

Background : Infliximab is an effective therapy in adult patients with refractory and fistulizing Crohns disease. Experience in children is still limited.

Inflammatory bowel disease in children and adolescents in Italy: data from the pediatric national IBD register (1996-2003).

Background: The purpose was to assess in Italy the clinical features at diagnosis of inflammatory bowel disease (IBD) in children. Methods: In 1996 an IBD register of disease onset was established on a national scale. Results: Up to the end of 2003, 1576 cases of pediatric IBD were recorded: 810 (52%) ulcerative colitis (UC), 635 (40%) Crohns disease (CD), and 131 (8%) indeterminate colitis (IC). In the period 1996–2003 an increase of IBD incidence from 0.89 to 1.39/105 inhabitants aged <18 years was observed. IBD was more frequent among children aged between 6 and 12 years (57%) but 20% of patients had onset of the disease under 6 years of age; 28 patients were <1 year of age. Overall, 11% had 1 or more family members with IBD. The mean interval between onset of symptoms and diagnosis was higher in CD (10.1 months) and IC (9 months) versus UC (5.8 months). Extended colitis was the most frequent form in UC and ileocolic involvement the most frequent in CD. Upper intestinal tract involvement was present in 11% of CD patients. IC locations were similar to those of UC. Bloody diarrhea and abdominal pain were the most frequent symptoms in UC and IC, and abdominal pain and diarrhea in CD. Extraintestinal symptoms were more frequent in CD than in UC. Conclusions The IBD incidence in children and adolescents in Italy shows an increasing trend for all 3 pathologies. UC diagnoses exceeded CD.

Pediatric ulcerative colitis associated with primary sclerosing cholangitis: a distinct form of inflammatory bowel disease? the clinical relevance of anti-lactoferrin antibodies.

was below the threshold necessary to elicit clinical symptoms and cause frequent relapses and long-term sequelae. It is possible that pain and the other symptoms only occur when the damage involves deep layers of the bowel wall in IBD. Likewise, long-term complications such as strictures and cancer may only result from sustained inflammation and loss of tissue, the main trigger of repair processes. As reported by Baars et al, most patients (87%) with mucosal damage in their study had a mild score on the Mayo scale (i.e., no tissue loss), while a minority had erosions and ulcerations. Regardless of the explanation at the basis of the authors’ findings (and with the limitations outlined above), this study may call into question the practice advocated by some to achieve complete muco-sal healing in patients with IBD when commencing therapy. It may well be that being nearly there may be as good as being there. Indeed, it has been shown that a modest degree of inflammation in the postoperative setting in CD (endoscopic score ,2) does not carry a significant risk of clinical relapse. Whether this also applies to longstanding, spontaneously occurring CD is unknown. An answer to this important question—which may bear implications for pharmacoeconomics and drug safety— will require an appropriately designed, prospective study in which different degrees of mucosal inflammation are correlated with individual symptoms, therapy, and disease evolution over a sufficiently long follow-up time. A daunting task.

P221 - Lack of association of previously identified disease loci 10q12, 11p15, and 20q13 in IBD

P221 Lack of association of previously identified disease loci 10q12, 11p15, and 20q13 in IBD A. Latiano1 *, E. Colombo1, O. Palmieri1, M.R. Valvano1, T. Latiano1, G. Corritore1, R. D’Inca2, M. Vecchi3, R. Caprilli4, S. Ardizzone5, S. Nobile6, D. De Venuto7, C. Sferlazzas8, A. Staiano9, V. Lodde10, G. Iacono11, C. Bascietto12, B. Papadatou13, A. Marseglia14, M. Castro13, S. Cucchiara12, V. Annese1. 1Unit of Gastroenterology, San Giovanni Rotondo, Italy, 2Unit of Gastroenterology, Padova, Italy, 3Unit of Gastroenterology, San Donato Milanese, Milano, Italy, 4Unit of Gastroenterology, “La Sapienza”, Roma, Italy, 5Unit of Gastroenterology, “Sacco”, Milano, Italy, 6Unit of Pediatrics of SIGENP (Italian Society of Pediatric Gastroenterology, Hepatology and Nutrition), Ancona, Italy, 7SIGENP, Bari, Italy, 8SIGENP, Messina, Italy, 9SIGENP, Napoli, Italy, 10SIGENP, Padova, Italy, 11SIGENP, Palermo, Italy, 12SIGENP, “La Sapienza”, Roma, Italy, 13SIGENP, “Bambino Gesu”, Roma, Italy, 14SIGENP, San Giovanni Rotondo, Italy