title: Crohn's disease in a child: unusual presentation with severe osteoporosis.
abstract: Crohn's disease is a chronic inflammatory bowel disease characterized by transmural, granulomatous inflammation. In paediatric-onset Crohn's disease, the most frequent clinical features are abdominal pain, diarrhoea, fatigue and weight loss. Delayed puberty, growth retardation and osteoporosis might, however, be the predominant signs of the disease. This paper reports the case of a 13-year-old girl with Crohn's disease diagnosed at the age of 11 years, with classic gastrointestinal symptoms in the previous few months, but with severe osteoporosis at onset. The child has been on infliximab therapy for 1 year, with complete control of the disease. Therapy with infliximab appears to influence bone metabolism, bone formation and resorption, and that improvement seems to be independent of the clinical response to the drug. Infliximab has recently been approved for paediatric use, which has been a great improvement for a group of patients lacking therapeutic options.
authors.affiliation: Pediatric Gastroenterology Unit, Hospital Pediatrico, Av. Bissaya Barreto, 3000 Coimbra, Portugal.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Ferreira
authors.forename: Susana
authors.initials: S
authors.lastname: Almeida
mesh_terms: D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D050071:Bone Density Conservation Agents / Q000627:therapeutic use; D002648:Child; D003424:Crohn Disease / Q000150:complications / Q000188:drug therapy; D004164:Diphosphonates / Q000627:therapeutic use; D018450:Disease Progression; D005260:Female; D006801:Humans; D000069285:Infliximab; D010012:Osteogenesis / Q000187:drug effects*; D010024:Osteoporosis / Q000188:drug therapy / Q000209:etiology*; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
chemical_list: D000893:Anti-Inflammatory Agents; D000911:Antibodies, Monoclonal; D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab