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The Natural History of Crohn Disease in Children

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Abstract

The natural history of Crohn disease (CD) and ulcerative colitis (UC) is characterized by recurrent exacerbations interspersed with periods of inactive disease. The goal of therapy should be to induce and maintain clinical remission and strive for endoscopic healing of the intestinal mucosa in order to improve the quality of life. Common complications include failure to thrive and impaired psychosocial development. The advent of infliximab has been very beneficial for pediatric patients suffering from CD and UC. In children and young adolescents, the short-term response and remission rates are high. Infliximab in children with IBD has shown to be steroid sparing and restores growth, two most important goals of therapy in this patient group. Systematic maintenance dosing with infliximab infusions (5 mg/kg) every 8 weeks is superior to episodic therapy or infusions every 12 weeks in maintaining response and remission. The safety profile of infliximab is overall favorable although continued vigilance remains necessary for the occurrence of infrequent but serious events, including opportunistic infection and malignancies, especially in patients with concomitant immunosuppressive treatment.

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Authors and Affiliations

  1. Department of Pediatrics, Division of Pediatric Gastroenterology and Nutrition, Steven and Alexandra Cohen Children’s Medical Center of New York, 269-01 76th Avenue, New Hyde Park, NY, 11040, USA

    James F. Markowitz MD

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  1. James F. Markowitz MD
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Correspondence to James F. Markowitz MD .

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Editors and Affiliations

  1. Perelman School of Medicine, The Children’s Hospital of Philadelphia, University of Pennsylvania, 34th St. & Civic Ctr. Blvd., Philadelphia, 19104, Pennsylvania, USA

    Petar Mamula

  2. School of Medicine--Greenville, Pediatric Gastroenterology & Nutrition, University of South Carolina, 200 Patewood Drive, Suite A-140, Greenville, 29615, South Carolina, USA

    Jonathan E. Markowitz

  3. Perelman School of Medicine, The Children's Hospital of Philadelphia, University of Pennsylvania, 34th St. & Civic Ctr. Blvd., Philadelphia, 19104, Pennsylvania, USA

    Robert N. Baldassano

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Markowitz, J.F. (2013). The Natural History of Crohn Disease in Children. In: Mamula, P., Markowitz, J., Baldassano, R. (eds) Pediatric Inflammatory Bowel Disease. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-5061-0_7

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  • DOI: https://doi.org/10.1007/978-1-4614-5061-0_7

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