Infliximab and pediatric stricturing Crohn's disease: a possible alternative to surgery? Experience of seven cases

Acta Gastroenterol Belg. 2012 Mar;75(1):58-60.

Abstract

Introduction: 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.

Aim: To assess the efficacy of IFX treatment for pediatric stricturing CD.

Patients and 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.

Case series: 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.

Conclusion: Our data support the efficacy of IFX in pediatric CD, including the stricturing phenotype.

MeSH terms

  • Adolescent
  • Antibodies, Monoclonal / therapeutic use*
  • Child
  • Crohn Disease / drug therapy*
  • Female
  • Gastrointestinal Agents / therapeutic use*
  • Humans
  • Infliximab
  • Male
  • Prospective Studies
  • Retrospective Studies
  • Treatment Outcome

Substances

  • Antibodies, Monoclonal
  • Gastrointestinal Agents
  • Infliximab