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Sathiyasekaran M, Ganesh R, Natarajan S. Other Causes of Chronic Diarrhea in Children. Indian J Pediatr 2024; 91:606-613. [PMID: 38051444 DOI: 10.1007/s12098-023-04918-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 10/23/2023] [Indexed: 12/07/2023]
Abstract
Chronic diarrhea is still an important cause of morbidity and mortality in children. There are several causes of chronic diarrhea which may be due to intestinal, extra-intestinal or underlying systemic diseases. The etiology varies depending on the age of onset and may include both common and uncommon disorders. In this article some of the uncommon disorders such as immune deficiencies, intestinal lymphangiectasias, drug induced diarrhea, eosinophilic gastrointestinal disorders, endocrinopathies, neuroendocrine secretory tumors, malignancy and factitious diarrhea have been included. Though these disorders are uncommon it is essential that they are considered in select situations as detailed below and evaluated so that definitive therapy may be offered.
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Affiliation(s)
- Malathi Sathiyasekaran
- Department of Pediatric Gastroenterology & Hepatology, Rainbow Children's Hospital, Chennai, 600015, Tamil Nadu, India
| | - R Ganesh
- Department of General Pediatrics & Inherited Metabolic Diseases, Rainbow Children's Hospital, Chennai, 600015, Tamil Nadu, India.
| | - Suresh Natarajan
- Department of General Pediatrics & Pediatric Allergy, Rainbow Children's Hospital, Chennai, 600015, Tamil Nadu, India
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AlYamany R, Kharfan-Dabaja MA, Hamadani M, Alshaibani A, Aljurf M. The Evolution of Our Understanding of Immunoproliferative Small Intestinal Disease (IPSID) over Time. Curr Oncol 2022; 29:3759-3769. [PMID: 35621691 PMCID: PMC9139652 DOI: 10.3390/curroncol29050301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 05/14/2022] [Accepted: 05/18/2022] [Indexed: 11/16/2022] Open
Abstract
Immunoproliferative small intestinal disease (IPSID) is an uncommon disease with a higher prevalence in the developing world. IPSID diagnosis relies mainly on a tissue biopsy and a high index of suspicion. Treatment options are variable; however, they mainly include anthracycline-based chemotherapy with or without antibiotics in advanced stages. Because of the paucity of IPSID, our perception of the disease remains narrow, and investigating the optimal lines of therapy and prevention without a complete comprehension of the disease is challenging. In our review, we explore the expansion of knowledge about IPSID, which has been developing over the years, to help increase the detection of IPISD cases and further research the most appropriate lines of therapy and prevention.
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Affiliation(s)
- Ruah AlYamany
- Section of Hematology and Bone Marrow Transplant, King Faisal Specialist Hospital and Research Center, Riyadh 11564, Saudi Arabia; (A.A.); (M.A.)
- Correspondence:
| | - Mohamed A. Kharfan-Dabaja
- Division of Hematology-Oncology, Blood and Marrow Transplantation Program, Mayo Clinic, Jacksonville, FL 32224, USA;
| | - Mehdi Hamadani
- BMT and Cellular Therapy Program, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI 53226, USA;
| | - Alfadel Alshaibani
- Section of Hematology and Bone Marrow Transplant, King Faisal Specialist Hospital and Research Center, Riyadh 11564, Saudi Arabia; (A.A.); (M.A.)
| | - Mahmoud Aljurf
- Section of Hematology and Bone Marrow Transplant, King Faisal Specialist Hospital and Research Center, Riyadh 11564, Saudi Arabia; (A.A.); (M.A.)
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Evangelista-Leite D, Affonso Madaloso B, Shouta Yamashita B, Enrico Aloise F, Polito Verdasca L, Lopes de Mello M, Murata Hayashi R, Zimberg Chehter E. Treating chronic diarrhea: A systematic review on Immunoproliferative Small Intestinal Disease (IPSID). PLoS One 2021; 16:e0253695. [PMID: 34270561 PMCID: PMC8284658 DOI: 10.1371/journal.pone.0253695] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 06/10/2021] [Indexed: 01/10/2023] Open
Abstract
Immunoproliferative Small Intestinal Disease (IPSID) is a disease characterized by extra-nodal marginal zone B-cell lymphoma with villous atrophy in the small intestine, causing chronic intermittent non-bloody diarrhea. Although originally associated with the Mediterranean region, this disease is present in many countries worldwide and may have been underreported due to its complicated diagnosis and scarce scientific literature, especially in regards to treatment. This study aims to review IPSID clinical features, therapeutic options, and treatment outcomes to help physicians identify and treat IPSID. Using PRISMA guidelines, a systematic review of articles was conducted on PubMed database with search terms including IPSID, therapy, treatment, and outcomes. Inclusion and exclusion criteria were used to select 33 English language articles published from the year 2000-2020 that included relevant clinical information about IPSID treatment. Data were extracted independently by at least two authors to reduce the introduction of potential bias. There were 22 case reports, 7 reviews, 1 research article, 1 prospective study, 1 letter to the editor and 1 memoriam in which 76 patients were identified. Epidemiological analysis showed a mean patient age of 32 years old, 2.4:1 mal to female ratio and heterogeneous ethnicities, with 16 Europeans (43.2%) and 12 Asians (32.4%). Chief symptoms included chronic diarrhea (53/76, 69.7%), weight loss (49/76, 64.4%), malabsorption (38/76, 50%), abdominal pain (32/76, 42.1%), and finger clubbing (24/76, 31.6%). Patients stratified into the early disease stage (Galian A) were treated with tetracycline antibiotics, corticosteroids, and non-pharmacological supplements with mostly with complete or partial remission. Late stages (Galian B or C), were treated mostly with anthracycline-based chemotherapy, and occasionally surgery, radiotherapy, or rituximab. This work offers a targeted approach to diagnosing and treating IPSID to aid physicians and serve as a treatment guideline recommendation for future public policies and clinical studies.
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Affiliation(s)
- Daniele Evangelista-Leite
- Department of Gastroenterology, School of Medicine, Faculdade de Medicina do ABC, Santo André, São Paulo, Brazil
| | - Breno Affonso Madaloso
- Department of Gastroenterology, School of Medicine, Faculdade de Medicina do ABC, Santo André, São Paulo, Brazil
| | - Bruno Shouta Yamashita
- Department of Gastroenterology, School of Medicine, Faculdade de Medicina do ABC, Santo André, São Paulo, Brazil
| | - Francesco Enrico Aloise
- Department of Gastroenterology, School of Medicine, Faculdade de Medicina do ABC, Santo André, São Paulo, Brazil
| | - Lucas Polito Verdasca
- Department of Gastroenterology, School of Medicine, Faculdade de Medicina do ABC, Santo André, São Paulo, Brazil
| | - Murilo Lopes de Mello
- Department of Gastroenterology, School of Medicine, Faculdade de Medicina do ABC, Santo André, São Paulo, Brazil
| | - Renan Murata Hayashi
- Department of Gastroenterology, School of Medicine, Faculdade de Medicina do ABC, Santo André, São Paulo, Brazil
| | - Ethel Zimberg Chehter
- Department of Gastroenterology, School of Medicine, Faculdade de Medicina do ABC, Santo André, São Paulo, Brazil
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