Fawaz Leo, Slim Yousif, Freswick Peter N
Pediatric Gastroenterology Fellowship-Children's Hospital of Michigan, Detroit, MI 48201, USA.
Family Medicine Residency-Wayne State University, Detroit, MI 48201, USA.
Reports (MDPI). 2024 Sep 24;7(4):81. doi: 10.3390/reports7040081.
The treatment for pediatric Crohn's disease (CD) has shifted over the years from steroids and immunomodulators to biologics with the goal of histological and clinical remission. Endoscopic balloon dilation (EBD) has been utilized for stricturing disease, even in the pediatric population. EBD has been shown to be effective and minimally invasive, though historically, has been performed on patients with persistent mucosal inflammation. As such, intralesional corticosteroid (ILC) injections have been traditionally utilized during EBD. However, intralesional corticosteroid efficacy among pediatrics patients in deep endoscopic remission is unknown. We report four patients that demonstrated at least initial successful dilations without intralesional steroid injections. The use of ILC injections during routine EBDs in pediatric patients should be further explored in randomized control trials.
多年来，小儿克罗恩病（CD）的治疗已从使用类固醇和免疫调节剂转变为使用生物制剂，目标是实现组织学和临床缓解。内镜球囊扩张术（EBD）已用于治疗狭窄性疾病，甚至在儿科患者中也有应用。EBD已被证明是有效的且微创的，不过从历史上看，该操作是在存在持续性黏膜炎症的患者身上进行的。因此，在EBD期间传统上会使用病灶内注射皮质类固醇（ILC）。然而，病灶内注射皮质类固醇在深度内镜缓解的儿科患者中的疗效尚不清楚。我们报告了4例患者，他们在未进行病灶内类固醇注射的情况下至少初步成功进行了扩张。在儿科患者的常规EBD中使用ILC注射应在随机对照试验中进一步探索。
