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December 1, 2016 - A screening test for non-alcoholic fatty liver disease (NAFLD)--a serious condition that may have lifelong health consequences--is recommended for all obese children aged nine to eleven years, according to clinical practice guidelines developed by the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN) and published in the Journal of Pediatric Gastroenterology and Nutrition (JPGN). Official journal of the European Society for Paediatric Gastroenterology, Hepatology and Nutrition and the NASPGHAN, the JPGN is published by Wolters Kluwer. The new guidelines, endorsed by the American Academy of Pediatrics, also outline recommendations for diagnosis, treatment, and follow-up care of children and adolescents with NAFLD. The recommendations were developed by a multidisciplinary Expert Committee on NAFLD, commissioned by the NASPGHAN. Dr. Miriam B. Vos of Emory University and Children's Healthcare of Atlanta is lead author of the new report, which is available on the JPGN website. Recommendations for Screening, Treatment and Follow-up of NAFLD in Children Nonalcoholic fatty liver disease refers to a range of conditions in which fatty deposits occur in the liver. It can progress to a more severe form, called nonalcoholic steatohepatitis (NASH), with inflammation and/or scarring of the liver. "NAFLD has rapidly evolved into the most common liver disease seen in the pediatric population and is a management challenge for the general pediatric practitioners, subspecialists, and health systems," Dr. Vos and coauthors write. Studies suggest that NAFLD may be present in 0.7 percent of two- to four-year-olds, and up to 38 percent of obese children and adolescents. The disease is commonly associated with other obesity-related conditions: diabetes and sleep apnea. While the long-term health impact of NAFLD remains unclear, affected children may be at increased risk for end-stage liver disease, type 2 diabetes, strokes, heart attacks, and liver cancer later in life. In adults, NAFLD has recently become the most common reason for liver transplant. The Expert Committee performed a comprehensive research review to make evidence-based recommendations for management of pediatric NAFLD. Key recommendations include: The Expert Committee highlights important areas for further research, emphasizing the need for high-quality pediatric studies of strategies for prevention, screening, diagnosis, and treatment. Dr. Vos and colleagues hope their recommendations will provide useful guidance for all professionals involved in assessing and managing NAFLD--providing an evidence-based approach that remains flexible and adjustable for individual patients and circumstances. Click here to read "NASPGHAN Clinical Practice Guideline for the Diagnosis and Treatment of Nonalcoholic Fatty Liver Disease in Children." Article: "NASPGHAN Clinical Practice Guideline for the Diagnosis and Treatment of Nonalcoholic Fatty Liver Disease in Children. (doi: 10.1097/MPG.0000000000001482) About The Journal of Pediatric Gastroenterology and Nutrition The Journal of Pediatric Gastroenterology and Nutrition provides a forum for original papers and reviews dealing with pediatric gastroenterology and nutrition, including normal and abnormal functions of the alimentary tract and its associated organs, including the salivary glands, pancreas, gallbladder, and liver. Particular emphasis is on development and its relation to infant and childhood nutrition. Wolters Kluwer is a global leader in professional information services. Professionals in the areas of legal, business, tax, accounting, finance, audit, risk, compliance and healthcare rely on Wolters Kluwer's market leading information-enabled tools and software solutions to manage their business efficiently, deliver results to their clients, and succeed in an ever more dynamic world. Wolters Kluwer reported 2015 annual revenues of €4.2 billion. The group serves customers in over 180 countries, and employs over 19,000 people worldwide. The company is headquartered in Alphen aan den Rijn, the Netherlands. Wolters Kluwer shares are listed on Euronext Amsterdam (WKL) and are included in the AEX and Euronext 100 indices. Wolters Kluwer has a sponsored Level 1 American Depositary Receipt program. The ADRs are traded on the over-the-counter market in the U.S. (WTKWY). Wolters Kluwer Health is a leading global provider of information and point of care solutions for the healthcare industry. For more information about our products and organization, visit http://www. , follow @WKHealth or @Wolters_Kluwer on Twitter, like us on Facebook, follow us on LinkedIn, or follow WoltersKluwerComms on YouTube.


News Article | February 28, 2017
Site: www.eurekalert.org

Bethesda, MD (Feb. 27, 2017) -- Patients with obesity need a multidisciplinary approach to achieve a healthy weight, and the American Gastroenterological Association (AGA) believes that gastroenterologists are in a unique position to lead the care team. To provide gastroenterologists with a comprehensive, multi-disciplinary process to guide and personalize innovative obesity care for safe and effective weight management, including a model for how to operationalize business issues, AGA has created an Obesity Practice Guide. The program includes an obesity program to help gastroenterologists manage their patients with obesity, as well as a framework focused on the business operational issues related to the management of obese patients, which are published in Clinical Gastroenterology and Hepatology, the clinical practice journal of the American Gastroenterological Association. "The epidemic of obesity continues at alarming rates with a high burden to our economy and society," said Sarah Streett, MD, an author of both papers, chair of the AGA Institute Practice Management and Economics Committee, and clinical associate professor and director of IBD Stanford University School of Medicine, CA. "The American Gastroenterological Association understands the importance of embracing obesity as a chronic, relapsing disease and supports a multidisciplinary approach to the management of obesity." POWER: Practice Guide on Obesity and Weight Management, Education and Resources1 Obesity is a major modifiable cause of diseases of the digestive tract that routinely goes unaddressed. Gastrointestinal disorders resulting from obesity are more frequent and often present sooner than type 2 diabetes mellitus and cardiovascular disease, which means gastroenterologists have an opportunity to address obesity and provide effective therapy for their patients. Patients who are overweight or obese are often seen by gastroenterologists due to gastroesophageal reflux disease (GERD) and its associated risks of Barrett's esophagus and esophageal cancer, gallstone disease, non-alcoholic fatty liver disease and non-alcoholic steatohepatitis, and colon cancer. As internists, specialists in digestive disorders and endoscopists, gastroenterologists are in a unique position to play an important role in the multidisciplinary treatment of obesity. "We created the practice guide on obesity and weight management to help gastroenterologists develop a multidisciplinary team and obesity care model for their practice, including patient goal setting, readiness assessment, evaluation, and treatment with diet, medication, and bariatric endoscopy and surgery," said Andres Acosta, MD, PhD, lead author of the paper and assistant professor of medicine, Clinical Enteric Neuroscience Translational and Epidemiological Research (C.E.N.T.E.R.), division of gastroenterology and hepatology, Mayo Clinic, Rochester, MN. "It is our hope that by working in a team-based approach, gastroenterologists can guide and personalize obesity care for safe and effective weight management for our patients." The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES), The Obesity Society (TOS), and North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN) contributed content to the POWER program, which was endorsed with input by the American Society for Gastrointestinal Endoscopy (ASGE), American Society for Metabolic and Bariatric Surgery (ASMBS), American Association for the Study of Liver Diseases (AASLD), Obesity Medicine Association (OMA) and Academy of Nutrition and Dietetics (AND). Episode-of-Care Framework for the Management of Obesity: Moving Towards High Value, High Quality Care2 The treatment of obesity needs a collaborative approach involving multiple stakeholders. AGA established an obesity episode of care model to develop a framework to support value-based management of patients with obesity, focusing on the provision of non-surgical and endoscopic services. The framework will help gastroenterology practices assess their ability to participate in and implement an episode of care for obesity, and understand the essentials of coding and billing for these services. The goal of episode framework is to provide gastroenterologists with strategies to obtain compensation for high value care, in a flexible format that can be adapted to the resources of both large and small practices. It is essential that data coordination take place between all members of the multi-disciplinary team who are providing therapeutic services to the patient to ensure high value continuity of care. The American Society for Metabolic and Bariatric Surgery (ASMBS), American Psychological Association (APA), American Pharmacists Association (APhA), and Academy of Nutrition and Dietetics (AND) contributed to the obesity episode of care framework. 1 Acosta A, Streett S et al.. White Paper AGA: POWER -- Practice Guide on Obesity and Weight Management, Education and Resources. Clinical Gastroenterology and Hepatology (2017), doi: 10.1016/j.cgh.2016.10.023. http://www.cghjournal.org/article/S1542-3565(16)30988-0/fulltext 2 Brill JV et al. White Paper AGA: An Episode-of-Care Framework for the Management of Obesity: Moving Towards High Value, High Quality Care. Clinical Gastroenterology and Hepatology (2017), doi: 10.1016/j.cgh.2017.02.002. http://www.cghjournal.org/article/S1542-3565(17)30146-5/pdf The American Gastroenterological Association is the trusted voice of the GI community. Founded in 1897, the AGA has grown to more than 16,000 members from around the globe who are involved in all aspects of the science, practice and advancement of gastroenterology. The AGA Institute administers the practice, research and educational programs of the organization. http://www. . The mission of Clinical Gastroenterology and Hepatology is to provide readers with a broad spectrum of themes in clinical gastroenterology and hepatology. This monthly peer-reviewed journal includes original articles as well as scholarly reviews, with the goal that all articles published will be immediately relevant to the practice of gastroenterology and hepatology. For more information, visit http://www. . Like AGA and Clinical Gastroenterology and Hepatology on Facebook. Join AGA on LinkedIn. Follow us on Twitter @AmerGastroAssn. Check out our videos on YouTube.


SAN FRANCISCO--(BUSINESS WIRE)--Jaguar Animal Health, Inc. (NASDAQ: JAGX) (Jaguar), an animal health company focused on developing and commercializing first-in-class gastrointestinal products for companion and production animals, foals, and high value horses, and Napo Pharmaceuticals, Inc. (Napo), a human health company developing and commercializing novel gastrointestinal prescription products from plants used traditionally in rainforest areas, today announced the appointment of Dr. Pravin Chaturvedi, a highly experienced drug development veteran who has spent more than 25 years in the pharmaceutical/biotech industry, as Chair of the combined company’s Scientific Advisory Board, following the expected close of the proposed merger of Jaguar and Napo. Dr. Chaturvedi has served as Chair of Napo’s Scientific Advisory Board since March 27, 2017. Dr. Chaturvedi is responsible for providing direction on strategy, tactics and oversight regarding advancing the development and commercialization of the companies’ drug pipelines, including, but not limited to, Mytesi® and SB-300. From 2006 to 2013, Dr. Chaturvedi served as Napo's Chief Scientific Officer and has remained a scientific adviser to the company since 2014. His track record of successful development includes participating in and/or leading development efforts for seven drugs, including Napo’s Mytesi® (crofelemer) product, which is approved by the U.S. FDA for the symptomatic relief of noninfectious diarrhea in adults with HIV/AIDS on antiretroviral therapy. For this indication, Dr. Chaturvedi led the key opinion leader efforts that contributed to the successful use of adaptive clinical trial design for the Mytesi® pivotal trial and its approval by the FDA. As announced March 31, 2017, Napo and Jaguar have entered a definitive merger agreement. Napo and Jaguar are in the process of evaluating potential follow-on indications for Mytesi® as part of the anticipated combination of the product pipelines of the two companies. Dr. Chaturvedi is chairing the investigation of Mytesi® for possible follow-on indications, which include chemotherapy-induced diarrhea, irritable bowel syndrome (IBS), for which proof of concept data is already in hand, inflammatory bowel diseases (IBD) and diarrhea resulting from hospital-acquired infections such as Clostridium difficile, a bacterium that is the most common cause of infectious diarrhea in hospital settings. Napo recently convened a Scientific Advisory Board meeting with expert gastroenterologists, who provided advice on study populations and designs in IBS and IBD. As Douglas Drossman, MD, Professor Emeritus at the University of North Carolina, who is a gastroenterologist in private practice at Drossman Gastroenterology, noted, “The safety profile of crofelemer constitutes an advantage that differentiates it from many other gastrointestinal products.” Mytesi® is also being explored for treatment of important orphan gastrointestinal indications such as congenital diarrheal disorders (CDD) and diarrhea associated with short-bowel syndrome (SBS). CDDs are a group of rare, chronic intestinal channel diseases characterized by large, watery stools containing an excess of chloride and sodium, lifelong diarrhea, and a lifelong need for nutritional intake with a feeding tube. CDDs are related to specific genetic defects inherited as autosomal recessive traits, and the incidence of CCDs is much more prevalent in regions where consanguineous marriage is part of the culture. Patients with SBS are born with a substantial shortening of the small intestine, to a mean length of 50 cm, compared with a normal length at birth of 190-280 cm. This could be due to either a genetic disorder or pre-mature birth. In regions such as the United Arab Emirates and Saudi Arabia, both CDD and SBS occur with much higher incidence. Napo has recently visited with medical centers in this region. “With the early and extreme morbidity and mortality suffered by CDD and SBS patients, we welcome the opportunity to participate in the investigation of a novel drug to address the devastating diarrhea and dehydration caused by these lifelong diseases for which there is currently no available treatment except parenteral nutrition, and help limit the suffering of patients and their family members,” stated Dr. Mohamad Miqdady, Chief of Pediatric Gastroenterology, Hepatology & Nutrition at Sheikh Khalifa Medical City in Abu Dhabi. Dr. Chaturvedi is also providing oversight for development of Napo’s proprietary second-generation anti-secretory agent for cholera—a possible indication that may present Napo with an opportunity for an FDA tropical disease priority review voucher. Under FDA regulations, the sponsor of a human drug application for a qualified tropical disease may be eligible for a priority review voucher, which can be used to obtain priority review for any subsequent human drug application submitted to FDA. These vouchers, which are transferable, have recently sold for $125 million - $350 million, and provide an immediate return on investment for the development of a novel product for important indications. “I am thrilled to be supporting Napo’s and Jaguar’s shared mission to change the global standard of care for gastrointestinal diseases,” stated Dr. Chaturvedi. “I look forward to evaluating potential multiple follow-on gastrointestinal indications for Mytesi®, and leveraging the collective expertise of our team in advancing drug development through innovative approaches such as the adaptive clinical trial design that led to the FDA approval of Mytesi® for its current indication of treating noninfectious diarrhea in adults with HIV/AIDS on antiretroviral therapy.” “We are very pleased that Dr. Chaturvedi has returned to support these principal development activities,” Conte commented, “which, if approved, will complement our current sales of Mytesi® for noninfectious diarrhea in adult HIV/AIDS patients on antiretroviral therapy. We consider Mytesi® a ‘pipeline within a product’, and Napo has global unencumbered rights to this novel first-in-class anti-secretory agent with multiple potential follow-on indications.” Dr. Chaturvedi has co-founded and led multiple biotech enterprises including Scion, IndUS and Oceanyx, and has served as the CEO or CSO for Scion, IndUS, Napo, and Oceanyx and is the CEO for Pivot Pharmaceuticals. Over his career, Dr. Chaturvedi led discovery and/or development activities for several new chemical entities (NCEs) and has participated in the discovery and/or development of novel drugs for treatment of HIV, hepatitis C, epilepsy and Alzheimer's disease. Earlier in his career, Dr. Chaturvedi was head of lead evaluation at Vertex Pharmaceuticals and was in the preclinical group at Alkermes. He started his career in the product development group at Parke-Davis/Warner-Lambert Company (now Pfizer). Dr. Chaturvedi holds a Ph.D. in Pharmaceutical Sciences from West Virginia University and a Bachelor's in Pharmacy from the University of Bombay. The proposed merger of Jaguar and Napo remains subject to customary conditions to closing. Upon the consummation of the merger, Jaguar’s name will be changed to Jaguar Health, Inc., and Napo will operate as a wholly-owned subsidiary of Jaguar, focused on human health. Subject to the conditions to closing, the proposed merger is expected to close by the end of July 2017. Mytesi® (crofelemer) is an antidiarrheal indicated for the symptomatic relief of noninfectious diarrhea in adult patients with HIV/AIDS on antiretroviral therapy (ART). Mytesi® is not indicated for the treatment of infectious diarrhea. Rule out infectious etiologies of diarrhea before starting Mytesi®. If infectious etiologies are not considered, there is a risk that patients with infectious etiologies will not receive the appropriate therapy and their disease may worsen. In clinical studies, the most common adverse reactions occurring at a rate greater than placebo were upper respiratory tract infection (5.7%), bronchitis (3.9%), cough (3.5%), flatulence (3.1%), and increased bilirubin (3.1%). More information and complete Prescribing Information are available at Mytesi.com. Crofelemer, the active ingredient in Mytesi®, is a botanical (plant-based) drug extracted and purified from the red bark sap of the medicinal Croton lechleri tree in the Amazon rainforest. Napo has established a sustainable harvesting program for crofelemer to ensure a high degree of quality and ecological integrity. San Francisco-based Napo Pharmaceuticals, Inc. focuses on the development and commercialization of proprietary pharmaceuticals for the global marketplace in collaboration with local partners. For more information, please visit www.napopharma.com. Jaguar Animal Health, Inc. is an animal health company focused on developing and commercializing first-in-class gastrointestinal products for companion and production animals, foals, and high value horses. Canalevia™ is Jaguar’s lead prescription drug product candidate, intended for the treatment of various forms of diarrhea in dogs. Equilevia™ (formerly referred to as SB-300) is Jaguar’s prescription drug product candidate for the treatment of gastrointestinal ulcers in horses. Canalevia™ and Equilevia™ contain ingredients isolated and purified from the Croton lechleri tree, which is sustainably harvested. Neonorm™ Calf and Neonorm™ Foal are the Company’s lead non-prescription products. Neonorm™ is a standardized botanical extract derived from the Croton lechleri tree. Canalevia™ and Neonorm™ are distinct products that act at the same last step in a physiological pathway generally present in mammals. Jaguar has nine active investigational new animal drug applications, or INADs, filed with the FDA and intends to develop species-specific formulations of Neonorm™ in six additional target species, formulations of Equilevia™ in horses, and Canalevia™ for cats and dogs. For more information about Jaguar, please visit www.jaguaranimalhealth.com. Certain statements in this press release constitute “forward-looking statements.” These include statements regarding the development, approval and sales of potential follow-on indications of Mytesi®, the proposed merger between Jaguar and Napo, Jaguar’s intention to develop species-specific formulations of Neonorm™ in additional target species, and the Company’s plan to develop formulations of Canalevia™ for cats, horses and dogs. In some cases, you can identify forward-looking statements by terms such as “may,” “will,” “should,” “expect,” “plan,” “aim,” “anticipate,” “could,” “intend,” “target,” “project,” “contemplate,” “believe,” “estimate,” “predict,” “potential” or “continue” or the negative of these terms or other similar expressions. The forward-looking statements in this release are only predictions. Jaguar has based these forward-looking statements largely on its current expectations and projections about future events. These forward-looking statements speak only as of the date of this release and are subject to a number of risks, uncertainties and assumptions, some of which cannot be predicted or quantified and some of which are beyond Jaguar’s control. Except as required by applicable law, Jaguar does not plan to publicly update or revise any forward-looking statements contained herein, whether as a result of any new information, future events, changed circumstances or otherwise.


AMBLER, Pa., May 23, 2017 /PRNewswire/ -- The Celiac Disease Foundation and the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN) announce the release of the NASPGHAN Clinical Guide for Pediatric Celiac Disease, an easy-to-use and convenient...


DBV Technologies Highlights Research Presentation of EPIT® for the Treatment of Crohn's Disease at Digestive Disease Week 2017 DBV Technologies (Euronext: DBV - ISIN: FR0010417345 - Nasdaq Stock Market: DBVT) today announced the presentation of a preclinical poster highlighting the therapeutic potential of epicutaneous immunotherapy (EPIT) in inflammatory gastrointestinal diseases at Digestive Disease Week (DDW) in Chicago, Illinois, May 6-9, 2017. The poster (Su1838), entitled "Tolerance with Viaskin requires TGF-b and can be utilized as a Treatment of Intestinal Inflammation in Murine Models," was accepted as a Poster of Distinction and presented by Dr. David Dunkin, Department of Pediatric Gastroenterology and The Mindich Child Health and Development Institute, The Icahn School of Medicine at Mount Sinai, New York, NY, on Sunday, May 7, from 12-2 pm CT. In this preclinical study, epicutaneous treatment with a 100 µg dose of Viaskin-Ovalbumin was associated with the induction of ovalbumin-specific regulatory T cells (Tregs) migrating to the gut and abrogating colitis and ileitis in mice via bystander suppression. EPIT was observed to increase Foxp3, LAP+ Tregs and TGF-b secretion in animal models, supporting the potential clinical application of EPIT in the treatment of Crohn's disease. In February 2014, DBV Technologies and The Icahn School of Medicine at Mount Sinai entered into a research collaboration to investigate the use of the Viaskin technology for the treatment of Crohn's disease. In December 2015, additional preclinical data supporting Viaskin's application in Crohn's was presented at the Crohn's & Colitis Foundation of America Advances in Inflammatory Bowel Diseases (AIBD) meeting in Orlando, Florida. About Crohn's disease Crohn's disease is a chronic inflammatory disease of the gastrointestinal tract, mainly characterized by abdominal pain, diarrhea and various digestive and non-digestive complications. There are no medications or surgical procedures that can cure Crohn's disease. One in five people with Crohn's are admitted to a hospital each year, and as many as half of those suffering from the disease will require surgery over a ten-year period. The incidence of Crohn's is increasing, especially in young children and infants. Both men and women can be affected by Crohn's disease, which is usually diagnosed between the ages of 15 - 30. About DBV Technologies  DBV Technologies is developing Viaskin®, a proprietary technology platform with broad potential applications in immunotherapy. Viaskin is based on epicutaneous immunotherapy, or EPIT®, DBV's method of delivering biologically active compounds to the immune system through intact skin. With this new class of self-administered and non-invasive product candidates, the company is dedicated to safely transforming the care of food allergic patients, for whom there are no approved treatments. DBV's food allergies programs include ongoing clinical trials of Viaskin Peanut and Viaskin Milk, and preclinical development of Viaskin Egg. DBV is also pursuing a human proof-of-concept clinical study of Viaskin Milk for the treatment of Eosinophilic Esophagitis, and exploring potential applications of its platform in vaccines and other immune diseases. DBV Technologies has global headquarters in Montrouge, France and New York, NY. Company shares are traded on segment A of Euronext Paris (Ticker: DBV, ISIN code: FR0010417345), part of the SBF120 index, and traded on the Nasdaq Global Select Market in the form of American Depositary Shares (each representing one-half of one ordinary share) (Ticker: DBVT). For more information on DBV Technologies, please visit our website: www.dbv-technologies.com Forward Looking Statements This press release may contain forward-looking statements and estimates, including statements regarding the potential of Viaskin to treat Crohn's disease. These forward-looking statements and estimates are not promises or guarantees and involve substantial risks and uncertainties. At this stage, the products of the Company have not been authorized for sale in any country. Among the factors that could cause actual results to differ materially from those described or projected herein include uncertainties associated generally with research and development, clinical trials and related regulatory reviews and approvals and the risk that historical preclinical results may not be predictive of future clinical trial results. A further list and description of these risks, uncertainties and other risks can be found in the Company's regulatory filings with the French Autorité des Marchés Financiers, the Company's Securities and Exchange Commission filings and reports, including in the Company's Annual Report on Form 20-F for the year ended December 31, 2016 and future filings and reports by the Company. Existing and prospective investors are cautioned not to place undue reliance on these forward-looking statements and estimates, which speak only as of the date hereof. Other than as required by applicable law, DBV Technologies undertakes no obligation to update or revise the information contained in this Press Release.


Fatima A.,Pediatric Gastroenterology | Gibson D.P.,Oakland University
Pediatrics | Year: 2014

Henoch-Schönlein purpura (HSP) is the most common vasculitis in children. It is a disorder of the inflammatory cascade leading to immunoglobulin A deposition and leukocytoclastic vasculitis of small vessels of skin, kidneys, joints, and gastrointestinal (GI) tract. A wide variety of GI manifestations are seen in ∼50% to 75% of patients with HSP. Diffuse colicky abdominal pain is the most common GI symptom. The small bowel is the most frequently involved GI site. Intussusception is rare but is the most common surgical complication. We report the case of a 2-year-old girl with a 5-day history of abdominal pain followed by a palpable purpuric rash. Her urinalysis, complete blood cell count, and tests of renal function were normal. An acute abdominal series was unremarkable initially, and abdominal ultrasound imaging showed ascites and thickened small bowel loops. She was diagnosed with HSP. The abdominal pain worsened, and an abdominal computed tomography scan demonstrated distal small bowel wall thickening and pneumatosis intestinalis in the descending colon. She was started on total parenteral nutrition and antibiotics and placed on bowel rest. She was given 2 mg/kg of intravenous immunoglobulin. Her abdominal pain gradually improved over the next week, and a repeat computed tomography scan showed significant improvement of the small bowel wall thickening and pneumatosis. The purpuric rash improved, and her abdominal pain resolved. We report a case of HSP and pneumatosis intestinalis, an association that has not been reported previously.


News Article | November 7, 2016
Site: www.eurekalert.org

November 7, 2016 - Even after a year on a gluten-free diet, nearly 20 percent of children with celiac disease continue to have intestinal abnormalities (enteropathy) on repeat biopsies, reports a study in the Journal of Pediatric Gastroenterology and Nutrition, official journal of the European Society for Paediatric Gastroenterology, Hepatology and Nutrition and the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition. The journal is published by Wolters Kluwer. Symptom status and laboratory results do not predict which children will have persistent celiac enteropathy despite a gluten-free diet, according to the new research by Dr. Maureen Leonard of MassGeneral Hospital for Children, Boston. "These findings suggest that a revisitation of monitoring and management criteria of celiac disease in childhood," Dr. Leonard comments. New Questions on Assessing Response to Gluten-Free Diet in Celiac Disease The researchers reviewed the records of 103 children and adolescents with celiac disease treated at two medical centers. Patients with celiac disease have a characteristic pattern of intestinal damage caused by exposure to gluten, contained in wheat and other grains. The main treatment for celiac disease is a gluten-free diet--careful elimination of all gluten-containing foods from the diet. The children in the study had followed a gluten-free diet for an average of 2.4 years. About 90 percent were rated as having "excellent" adherence to their diet. The children also underwent intestinal endoscopy and biopsy (sampling of intestinal tissue) at least two times: when celiac disease was diagnosed and after at least one year on a gluten-free diet. The main reasons for repeat biopsy were persistent or new symptoms or abnormal laboratory test results. The study focused on the rate of persistent celiac enteropathy: gluten-induced damage to intestinal cells. Current guidelines for celiac disease treatment rely on laboratory tests to assess healing, rather than follow-up endoscopy and biopsy. The repeat biopsy results showed persistent celiac enteropathy in 19 percent of children. The presence of enteropathy could not be predicted by the presence of symptoms or by levels of IgA tissue transglutaminase antibodies (IgA tTG)--the main laboratory test used for monitoring celiac disease. At the time of the second biopsy, IgA tTG was elevated in 43 percent of children with persistent enteropathy and 32 percent with normal biopsies. In the past, children with celiac disease had routine follow-up biopsies to monitor healing in response to a gluten-free diet. In more recent years, laboratory tests such as IgA tTG have been used instead of biopsies. The study was prompted by growing evidence that many adults with celiac disease have persistent enteropathy, despite having no symptoms and normal IgA tTG levels. The results suggest that 1 out of 5 children with celiac disease may have persistent enteropathy, despite following their recommended gluten-free diet. Dr. Leonard and colleagues write: "While the long-term effects are not known, persistent enteropathy may predispose pediatric patients with celiac disease to future complications and suboptimal growth." While current guidelines do not recommend repeat biopsy, Dr. Leonard and colleagues note that it is the only way to confirm that celiac enteropathy has resolved. "These findings suggest the need not only for a baseline endoscopy to confirm the diagnosis of celiac disease but also consideration of a repeat biopsy to evaluate for remission," the researchers add. They call for further studies to confirm their findings, to better understand the response to a gluten-free diet, and to evaluate further treatment options. Click here to read "Value of IgA tTG in Predicting Mucosal Recovery in Children with Celiac Disease on a Gluten Free Diet." Article: "Value of IgA tTG in Predicting Mucosal Recovery in Children with Celiac Disease on a Gluten Free Diet" (doi: 10.1097/MPG.0000000000001460) About The Journal of Pediatric Gastroenterology and Nutrition The Journal of Pediatric Gastroenterology and Nutrition provides a forum for original papers and reviews dealing with pediatric gastroenterology and nutrition, including normal and abnormal functions of the alimentary tract and its associated organs, including the salivary glands, pancreas, gallbladder, and liver. Particular emphasis is on development and its relation to infant and childhood nutrition. Wolters Kluwer is a global leader in professional information services. Professionals in the areas of legal, business, tax, accounting, finance, audit, risk, compliance and healthcare rely on Wolters Kluwer's market leading information-enabled tools and software solutions to manage their business efficiently, deliver results to their clients, and succeed in an ever more dynamic world. Wolters Kluwer reported 2015 annual revenues of €4.2 billion. The group serves customers in over 180 countries, and employs over 19,000 people worldwide. The company is headquartered in Alphen aan den Rijn, the Netherlands. Wolters Kluwer shares are listed on Euronext Amsterdam (WKL) and are included in the AEX and Euronext 100 indices. Wolters Kluwer has a sponsored Level 1 American Depositary Receipt program. The ADRs are traded on the over-the-counter market in the U.S. (WTKWY). Wolters Kluwer Health is a leading global provider of information and point of care solutions for the healthcare industry. For more information about our products and organization, visit http://www. , follow @WKHealth or @Wolters_Kluwer on Twitter, like us on Facebook, follow us on LinkedIn, or follow WoltersKluwerComms on YouTube.


News Article | November 7, 2016
Site: www.sciencedaily.com

Even after a year on a gluten-free diet, nearly 20 percent of children with celiac disease continue to have intestinal abnormalities (enteropathy) on repeat biopsies, reports a study in the Journal of Pediatric Gastroenterology and Nutrition, official journal of the European Society for Paediatric Gastroenterology, Hepatology and Nutrition and the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition. The journal is published by Wolters Kluwer. Symptom status and laboratory results do not predict which children will have persistent celiac enteropathy despite a gluten-free diet, according to the new research by Dr. Maureen Leonard of MassGeneral Hospital for Children, Boston. "These findings suggest that a revisitation of monitoring and management criteria of celiac disease in childhood," Dr. Leonard comments. New Questions on Assessing Response to Gluten-Free Diet in Celiac Disease The researchers reviewed the records of 103 children and adolescents with celiac disease treated at two medical centers. Patients with celiac disease have a characteristic pattern of intestinal damage caused by exposure to gluten, contained in wheat and other grains. The main treatment for celiac disease is a gluten-free diet -- careful elimination of all gluten-containing foods from the diet. The children in the study had followed a gluten-free diet for an average of 2.4 years. About 90 percent were rated as having "excellent" adherence to their diet. The children also underwent intestinal endoscopy and biopsy (sampling of intestinal tissue) at least two times: when celiac disease was diagnosed and after at least one year on a gluten-free diet. The main reasons for repeat biopsy were persistent or new symptoms or abnormal laboratory test results. The study focused on the rate of persistent celiac enteropathy: gluten-induced damage to intestinal cells. Current guidelines for celiac disease treatment rely on laboratory tests to assess healing, rather than follow-up endoscopy and biopsy. The repeat biopsy results showed persistent celiac enteropathy in 19 percent of children. The presence of enteropathy could not be predicted by the presence of symptoms or by levels of IgA tissue transglutaminase antibodies (IgA tTG) -- the main laboratory test used for monitoring celiac disease. At the time of the second biopsy, IgA tTG was elevated in 43 percent of children with persistent enteropathy and 32 percent with normal biopsies. In the past, children with celiac disease had routine follow-up biopsies to monitor healing in response to a gluten-free diet. In more recent years, laboratory tests such as IgA tTG have been used instead of biopsies. The study was prompted by growing evidence that many adults with celiac disease have persistent enteropathy, despite having no symptoms and normal IgA tTG levels. The results suggest that 1 out of 5 children with celiac disease may have persistent enteropathy, despite following their recommended gluten-free diet. Dr. Leonard and colleagues write: "While the long-term effects are not known, persistent enteropathy may predispose pediatric patients with celiac disease to future complications and suboptimal growth." While current guidelines do not recommend repeat biopsy, Dr. Leonard and colleagues note that it is the only way to confirm that celiac enteropathy has resolved. "These findings suggest the need not only for a baseline endoscopy to confirm the diagnosis of celiac disease but also consideration of a repeat biopsy to evaluate for remission," the researchers add. They call for further studies to confirm their findings, to better understand the response to a gluten-free diet, and to evaluate further treatment options.

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