title: NASPGHAN Clinical Report: Surveillance, Diagnosis, and Prevention of Infectious Diseases in Pediatric Patients With Inflammatory Bowel Disease Receiving Tumor Necrosis Factor-α Inhibitors.
abstract: Children and adolescents with inflammatory bowel disease (IBD) receiving therapy with tumor necrosis factor α inhibitors (anti-TNFα) pose a unique challenge to health care providers in regard to the associated risk of infection. Published experience in adult populations with distinct autoinflammatory and autoimmune diseases treated with anti-TNFα therapies demonstrates an increased risk of serious infections with intracellular bacteria, mycobacteria, fungi, and some viruses; however, there is a paucity of robust pediatric data. With a rising incidence of pediatric IBD and increasing use of biologic therapies, heightened knowledge and awareness of infections in this population is important for primary care pediatricians, pediatric gastroenterologists, and infectious disease (ID) physicians. This clinical report is the result of a consensus review performed by pediatric ID and gastroenterology physicians detailing relevant published literature regarding infections in pediatric patients with IBD receiving anti-TNFα therapies. The objective of this document is to provide comprehensive information for prevention, surveillance, and diagnosis of infections based on current knowledge, until additional pediatric data are available to inform evidence-based recommendations.
authors.affiliation: *Infectious Diseases and Immunology, Host Defense Program, Nationwide Children's Hospital, The Ohio State University, Columbus, OH†Pediatric Infectious Diseases, Weill Cornell Medical Center, New York, NY‡Pediatric Infectious Diseases, Children's Medical Center Dallas, University of Texas Southwestern, Dallas, TX§Cohen Children's Medical Center, Hofstra North Shore-LIJ School of Medicine, Lake Success, NY||Pediatric Gastroenterology, Boston Children's Hospital, Harvard Medical School, Boston, MA#Division of Gastroenterology, Hepatology, and Nutrition, Nationwide Children's Hospital, The Ohio State University, Columbus, OH.
authors.forename: Monica I
authors.initials: MI
authors.lastname: Ardura
authors.forename: Sima S
authors.initials: SS
authors.lastname: Toussi
authors.forename: Jane D
authors.initials: JD
authors.lastname: Siegel
authors.forename: Ying
authors.initials: Y
authors.lastname: Lu
authors.forename: Athos
authors.initials: A
authors.lastname: Bousvaros
authors.forename: Wallace
authors.initials: W
authors.lastname: Crandall
mesh_terms: D000293:Adolescent; D002648:Child; D002662:Child Health Services; D005260:Female; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000188:drug therapy*; D008172:Lung Diseases, Fungal / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*; D008297:Male; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*
chemical_list: D014409:Tumor Necrosis Factor-alpha