Pediatric Gastroenterology, Department of Pediatrics, Division of Gastroenterology, Hepatology and Nutrition, Indiana University, 705 Riley Hospital Drive, ROC 4210, Indianapolis, IN 46202, USA. Electronic address: https://twitter.com/xtzhang.
Pediatric Gastroenterology, Division of Pediatric Gastroenterology, Liver Disease, and Nutrition, Cohen Children's Medical Center of New York, 1991 Marcus Avenue, Suite M100, Lake Success, NY 11042, USA.
Gastroenterol Clin North Am. 2023 Sep;52(3):535-548. doi: 10.1016/j.gtc.2023.05.007. Epub 2023 Jun 7.
Therapeutic options for the treatment of pediatric inflammatory bowel disease include aminosalicylates, enteral nutrition, corticosteroids, immunomodulators, biologics, and emerging small molecule agents. Infectious risk due to systemic immunosuppression should be mitigated by appropriate screening before therapy initiation. Rare but serious malignancies have been associated with thiopurine use alone and in combination with anti-tumor necrosis factor agents, often in the setting of a primary Epstein-Barr virus infection. Potential agent-specific adverse events such as cytopenias, hepatotoxicity, and nephrotoxicity warrant regular clinical and laboratory monitoring.
儿科炎症性肠病的治疗选择包括氨基水杨酸盐、肠内营养、皮质类固醇、免疫调节剂、生物制剂和新兴的小分子药物。由于全身免疫抑制，治疗前应通过适当的筛查来降低感染风险。单独使用硫嘌呤和联合使用抗肿瘤坏死因子制剂与罕见但严重的恶性肿瘤有关，通常发生在原发性 EBV 感染的情况下。潜在的药物特异性不良事件，如血细胞减少症、肝毒性和肾毒性，需要定期进行临床和实验室监测。
