Chandrakasan Shanmuganathan, Venkateswaran Suresh, Kugathasan Subra
Department of Pediatrics, Children's Health Care of Atlanta, Emory University School of Medicine, Atlanta, GA, USA; Division of Hematology, Oncology and BMT, Emory University School of Medicine, Atlanta, GA, USA.
Department of Pediatrics, Children's Health Care of Atlanta, Emory University School of Medicine, Atlanta, GA, USA; Division of Pediatric Gastroenterology, Emory University School of Medicine, Atlanta, GA, USA.
Pediatr Clin North Am. 2017 Feb;64(1):139-160. doi: 10.1016/j.pcl.2016.08.010.
This article discusses non-classical forms of inflammatory bowel disease (IBD) mainly occurs in infants and very young children. Defects in every aspect of the immune system, such as neutrophils, T-cell and B-cell lymphocytes, and macrophages are associated with IBD in infants. Also, non lympho-hematopoietic defects with primary defects in enterocytes can also lead to IBD-like manifestations. Clinical vignettes are presented and the genetic origins and possible management strategies are outlined. Early evaluation of these patients is important because identification of underlying immune defects would facilitate the use of better-targeted therapy for the specific genetic defect.
本文讨论主要发生在婴儿和幼儿中的非经典形式的炎症性肠病(IBD)。免疫系统各方面的缺陷,如中性粒细胞、T细胞和B细胞淋巴细胞以及巨噬细胞,都与婴儿的IBD有关。此外,肠上皮细胞存在原发性缺陷的非淋巴造血缺陷也可导致IBD样表现。文中展示了临床案例,并概述了其遗传起源和可能的管理策略。对这些患者进行早期评估很重要,因为识别潜在的免疫缺陷将有助于针对特定基因缺陷采用更有针对性的治疗方法。