title: Infliximab and pediatric stricturing Crohn's disease: a possible alternative to surgery? Experience of seven cases.
abstract: BACKGROUND
  Infliximab (IFX) is one of the treatments of choice for the different phenotypes of pediatric Crohn's disease (CD). Although it was initially feared that anti-TNFα treatment might cause bowel stenosis, recent studies have validated the efficacy of IFX as an anti-stricturing agent.
  
  
  OBJECTIVE
  To assess the efficacy of IFX treatment for pediatric stricturing CD.
  
  
  METHODS
  Data were obtained on pediatric patients treated at our tertiary level Pediatrics Department (years 2000-2010). Indications for IFX therapy included persistent disease activity (PCDAI > 20) unresponsive to corticosteroids and thiopurines. All patients treated with IFX underwent upper and lower intestinal endoscopy, abdominal ultrasound and magnetic resonance enterography.
  
  
  METHODS
  Among 44 pediatric CD patients, 21 were treated with IFX. Seven of these cases had luminal strictures and in 6 patients the inflammatory strictures disappeared after treatment with IFX. One child with ileal fibrotic stenosis (MR) required a surgical resection.
  
  
  CONCLUSIONS
  Our data support the efficacy of IFX in pediatric CD, including the stricturing phenotype.
authors.affiliation: Department of Pediatrics, Unit of Gastroenterology and Digestive Endoscopy, University Hospital of Padova, Padova, Italy. markgasp@gmail.com
authors.forename: Marco
authors.initials: M
authors.lastname: Gasparetto
authors.forename: Simone
authors.initials: S
authors.lastname: Corradin
authors.forename: Francesca
authors.initials: F
authors.lastname: Vallortigara
authors.forename: Mara
authors.initials: M
authors.lastname: Cananzi
authors.forename: Graziella
authors.initials: G
authors.lastname: Guariso
mesh_terms: D000293:Adolescent; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D002648:Child; D003424:Crohn Disease / Q000188:drug therapy*; D005260:Female; D005765:Gastrointestinal Agents / Q000627:therapeutic use*; D006801:Humans; D000069285:Infliximab; D008297:Male; D011446:Prospective Studies; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000911:Antibodies, Monoclonal; D005765:Gastrointestinal Agents; D000069285:Infliximab