Abstract: Background: We investigated a consecutive series of children with chronic enterocolitis and regressive develop
Posted: Tue Mar 15, 2022 2:53 pm
Abstract:
Background:
We investigated a consecutive series of children with chronic
enterocolitis and regressive developmental disorder.
Methods
12 children (mean age 6 years [range 3–10], 11 boys) were referred
to a paediatric gastroenterology unit with a history of normal
development followed by loss of acquired skills, including
language, together with diarrhoea and abdominal pain. Children
underwent gastroenterological, neurological, and developmental
assessment and review of developmental records. Ileocolonoscopy and
biopsy sampling, magnetic-resonance imaging (MRI),
electroencephalography (EEG), and lumbar puncture were done under
sedation. Barium follow-through radiography was done where
possible. Biochemical, haematological, and immunological profiles
were examined.
Findings
Onset of behavioural symptoms was associated, by the parents, with
measles, mumps, and rubella vaccination in eight of the 12
children, with measles infection in one child, and otitis media in
another. All 12 children had intestinal abnormalities, ranging from
lymphoid nodular hyperplasia to aphthoid ulceration. Histology
showed patchy chronic inflammation in the colon in 11 children and
reactive ileal lymphoid hyperplasia in seven, but no granulomas.
Behavioural disorders included autism (nine), disintegrative
psychosis (one), and possible postviral or vaccinal encephalitis
(two). There were no focal neurological abnormalities and MRI and
EEG tests were normal. Abnormal laboratory results were
significantly raised urinary methylmalonic acid compared with
agematched controls (p=0·003), low haemoglobin in four children,
and a low serum IgA in four children.
Interpretation
We identified associated gastrointestinal disease and developmental
regression in a group of previously normal children, which was
generally associated in time with possible environmental
triggers.
Meta Analysis urnal Club al Evidence + ce Updates Systematic Reviews Critically Appraised Sources ed/Filtered Randomized Controlled Trials Cohort Studies Unfiltered Case Control Studies Case Reports/ Case Series Background Information & Expert Opinion
Background:
We investigated a consecutive series of children with chronic
enterocolitis and regressive developmental disorder.
Methods
12 children (mean age 6 years [range 3–10], 11 boys) were referred
to a paediatric gastroenterology unit with a history of normal
development followed by loss of acquired skills, including
language, together with diarrhoea and abdominal pain. Children
underwent gastroenterological, neurological, and developmental
assessment and review of developmental records. Ileocolonoscopy and
biopsy sampling, magnetic-resonance imaging (MRI),
electroencephalography (EEG), and lumbar puncture were done under
sedation. Barium follow-through radiography was done where
possible. Biochemical, haematological, and immunological profiles
were examined.
Findings
Onset of behavioural symptoms was associated, by the parents, with
measles, mumps, and rubella vaccination in eight of the 12
children, with measles infection in one child, and otitis media in
another. All 12 children had intestinal abnormalities, ranging from
lymphoid nodular hyperplasia to aphthoid ulceration. Histology
showed patchy chronic inflammation in the colon in 11 children and
reactive ileal lymphoid hyperplasia in seven, but no granulomas.
Behavioural disorders included autism (nine), disintegrative
psychosis (one), and possible postviral or vaccinal encephalitis
(two). There were no focal neurological abnormalities and MRI and
EEG tests were normal. Abnormal laboratory results were
significantly raised urinary methylmalonic acid compared with
agematched controls (p=0·003), low haemoglobin in four children,
and a low serum IgA in four children.
Interpretation
We identified associated gastrointestinal disease and developmental
regression in a group of previously normal children, which was
generally associated in time with possible environmental
triggers.
- Abstract Background We Investigated A Consecutive Series Of Children With Chronic Enterocolitis And Regressive Develop 1 (356.05 KiB) Viewed 56 times