tailieunhanh - Inflammatory Bowel Disease in Children and Adolescents: Recommendations for Diagnosis—The Porto Criteria

The prevalence of hypertension in children ranges from less than1%[10]. While pediatric hypertension was previously assumed to be secondary to renal, cardiovascular or endocrine causes, there is now increased evidence that it could be a part of a spectrum of essential hypertension, mainly linked to the obesity epidemic. The three most common symptoms of hypertension in children are head- ache, difficulty sleeping, and tiredness, all of which improve with treatment. Pediatricians can play a pivotal role in the early diagnosis and treatment of HT to reduce long- termcardiovascularmorbidity andmortality. Blood pressure should be measured routinely in every child starting at age three years and in children with comorbid conditions such as the presence. | Journal of Pediatric Gastroenterology and Nutrition 41 1-7 July 2005 Lippincott Williams Wilkins Philadelphia Medical Position Paper Inflammatory Bowel Disease in Children and Adolescents Recommendations for Diagnosis The Porto Criteria IBD Working Group of the European Society for Paediatric Gastroenterology Hepatology and Nutrition ESPGHAN ABSTRACT Ulcerative colitis and Crohn disease may present before the age of 20 years in 25 to 30 of all patients with inflammatory bowel disease. Reported incidence figures vary considerably depending on the collection of data. Multicenter multinational collaboration is needed when studying pediatric inflammatory bowel disease. The essential first step is uniformity in the workup and criteria used for diagnosis. The Porto diagnostic criteria presented here provide the tool that is needed. These criteria are the result of consensus reached by the ESPGHAN inflammatory bowel disease working group. Diagnosis of Crohn disease ulcerative colitis and indeterminate colitis is based on clinical signs and symptoms endoscopy and histology and radiology. Every child suspected of inflammatory bowel disease should undergo a complete diagnostic program consisting of colonoscopy with ileal intubation upper gastrointestinal endoscopy and in all cases except in definite ulcerative colitis radiologic contrast imaging of the small bowel. Multiple biopsies from all segments of the gastrointestinal tract are needed for a complete histologic evaluation. A diagnosis of indeterminate colitis cannot be made unless a full diagnostic program has been performed. JPGN 41 1-7 2005. Key Words IBD Pediatric Children Consensus Diagnosis Criteria. 2005 Lippincott Williams Wilkins INTRODUCTION Ulcerative colitis UC and Crohn disease CD may present before the age of 20 years in 25 to 30 of all patients with inflammatory bowel disease IBD 1 . In the pediatric age group several epidemiologic studies have been published with evidence suggesting that the incidence of