JPGN reportsPub Date : 2025-03-10eCollection Date: 2025-05-01DOI: 10.1002/jpr3.70014
Apoorva Nanagiri, Samantha Pravder, Sonia Solomon, Virender Tewari, Howard Bostwick
{"title":"Atypical hemolytic uremic syndrome: a rare complication of postendoscopic retrograde cholangiopancreatography pancreatitis.","authors":"Apoorva Nanagiri, Samantha Pravder, Sonia Solomon, Virender Tewari, Howard Bostwick","doi":"10.1002/jpr3.70014","DOIUrl":"10.1002/jpr3.70014","url":null,"abstract":"<p><p>Endoscopic retrograde cholangiopancreatography (ERCP) is a crucial procedure for diagnosing and managing conditions affecting the pancreas and biliary tract. The procedure can be technically challenging and carries risks of complications, with post-ERCP pancreatitis (PEP) being the most common. We report a case of a 16-year-old female who presented with cholelithiasis that progressed to choledocholithiasis which was removed using ERCP. Following this, she developed PEP and subsequently progressed to atypical hemolytic uremic syndrome, a rare complication reported in the pediatric literature.</p>","PeriodicalId":501015,"journal":{"name":"JPGN reports","volume":"6 2","pages":"193-195"},"PeriodicalIF":0.0,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12078042/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144096676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
JPGN reportsPub Date : 2025-03-05eCollection Date: 2025-05-01DOI: 10.1002/jpr3.70006
Seyma Eroglu, Sara Nandolia, Yujie Zhang, Lysandra Voltaggio, Anthony L Guerrerio
{"title":"Carbohydrate malabsorption mimicking immune dysregulation: A histological challenge.","authors":"Seyma Eroglu, Sara Nandolia, Yujie Zhang, Lysandra Voltaggio, Anthony L Guerrerio","doi":"10.1002/jpr3.70006","DOIUrl":"10.1002/jpr3.70006","url":null,"abstract":"<p><p>We report a case of neonatal-onset intractable diarrhea, where the patient's histologic findings suggested immune dysregulation. However, genetic testing revealed compound heterozygous variants in the <i>SLC5A1</i> gene. This case report adds to the existing literature by demonstrating that severe carbohydrate malabsorption can cause inflammatory histological features possibly secondary to small intestinal bacterial overgrowth.</p>","PeriodicalId":501015,"journal":{"name":"JPGN reports","volume":"6 2","pages":"174-176"},"PeriodicalIF":0.0,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12078038/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144096683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
JPGN reportsPub Date : 2025-03-03eCollection Date: 2025-05-01DOI: 10.1002/jpr3.70013
Vanessa Weisbrod, Nasim Khavari, Imad Absah, Dale Lee, Danny Mallon, Catherine Raber, Vahe Badalyan, Mary Shull, Ritu Verma, Ashley Dunn, Anava Wren, Farah Mardini, Lisa Fahey, Jocelyn Silvester, Tracy Ediger, Maureen Leonard, Javier A Lopez-Rivera, Hilary Jericho
{"title":"Gluten-free schooling: Navigating challenges and triumphs for children with celiac disease.","authors":"Vanessa Weisbrod, Nasim Khavari, Imad Absah, Dale Lee, Danny Mallon, Catherine Raber, Vahe Badalyan, Mary Shull, Ritu Verma, Ashley Dunn, Anava Wren, Farah Mardini, Lisa Fahey, Jocelyn Silvester, Tracy Ediger, Maureen Leonard, Javier A Lopez-Rivera, Hilary Jericho","doi":"10.1002/jpr3.70013","DOIUrl":"10.1002/jpr3.70013","url":null,"abstract":"<p><strong>Objectives: </strong>Celiac disease (CeD), an autoimmune disorder triggered by gluten ingestion, induces intestinal inflammation and varied symptoms. Treatment entails a strict gluten-free diet (GFD), posing challenges for students, especially in schools with limited food choices. Nonadherence worsens symptoms, yet research on CeD's impact on students is scarce.</p><p><strong>Methods: </strong>The CeliacKIDS study, conducted across 11 United States academic medical centers, evaluated gluten exposure risk in pediatric CeD patients via a cross-sectional survey from August 2020 to August 2021. Participants recruited from treating institutions were approved by respective Institutional Review Boards.</p><p><strong>Results: </strong>One hundred and sixty children aged 5-18 (65% female, 34% male, 1% other) participated. Only 12% had GF food options at school, 31% brought their own for celebrations, and 41% lacked gluten free (GF) snacks after school. Thirty-six percent lacked a 504 plan, with 5% misinformed. Hand hygiene concerns included 24% using sanitizer and 10% rarely washing hands before eating. Sixty-two percent disclosed CeD, 35% when prompted, and 3% refused, mainly 13-year-old males. Two percent hesitated to request GF options, and 2% consumed potentially gluten-containing food from friends.</p><p><strong>Conclusion: </strong>Many US schools provide GF accommodations under the Americans with Disabilities Act (ADA) but lack national standards. Diverse GF options and education on GF-safe practices are crucial for GFD adherence. Discrepancies in parent-child perceptions emphasize the need for better communication. Adolescents, particularly females aged 12-13 with 2+ years on a GF diet, face higher risks. Transparent family-school communication is vital for optimizing the school experience and ensuring GFD adherence. Comprehensive nationwide school training is essential for celiac patients' well-being.</p>","PeriodicalId":501015,"journal":{"name":"JPGN reports","volume":"6 2","pages":"99-106"},"PeriodicalIF":0.0,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12078044/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144096741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
JPGN reportsPub Date : 2025-02-28eCollection Date: 2025-05-01DOI: 10.1002/jpr3.12168
Jeanette Freeman, Steven D Miller, Brett J Hoskins
{"title":"Endoscopic removal of high-powered magnets from the appendiceal orifice in an asymptomatic child.","authors":"Jeanette Freeman, Steven D Miller, Brett J Hoskins","doi":"10.1002/jpr3.12168","DOIUrl":"10.1002/jpr3.12168","url":null,"abstract":"<p><p>Ingestion of multiple magnets can lead to serious complications, including foreign body appendicitis. Appendicitis usually develops when an object blocks the appendiceal orifice, though outcomes may vary from asymptomatic passage to acute inflammation. While several case reports have documented appendectomy for magnet-induced foreign body appendicitis, and one report described endoscopic removal of magnets in a patient with appendicitis, this case is the first to report successful endoscopic removal of high-powered magnets from the appendix in an asymptomatic child. This intervention potentially prevented the development of appendicitis and the need for surgery. This case highlights the importance of considering foreign body retention in the appendix when objects fail to progress beyond the right lower quadrant.</p>","PeriodicalId":501015,"journal":{"name":"JPGN reports","volume":"6 2","pages":"203-205"},"PeriodicalIF":0.0,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12078058/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144096730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
JPGN reportsPub Date : 2025-02-25eCollection Date: 2025-05-01DOI: 10.1002/jpr3.70003
Kanak V Kennedy, Jibraan A Fawad, Y Dana Neugut, Doris Valenzuela-Araujo, Alexander Coe, Tricia R Bhatti, Michael Acord, Michael D Manfredi, Petar Mamula, Kathleen M Loomes, Jefferson N Brownell
{"title":"SPNing our wheels-Pancreatic solid pseudopapillary neoplasm as an extraluminal etiology of persistent duodenal ulceration.","authors":"Kanak V Kennedy, Jibraan A Fawad, Y Dana Neugut, Doris Valenzuela-Araujo, Alexander Coe, Tricia R Bhatti, Michael Acord, Michael D Manfredi, Petar Mamula, Kathleen M Loomes, Jefferson N Brownell","doi":"10.1002/jpr3.70003","DOIUrl":"10.1002/jpr3.70003","url":null,"abstract":"<p><p>Pediatric upper gastrointestinal (GI) bleeding secondary to duodenal ulceration is a potentially serious and life-threatening condition with a broad differential diagnosis. We present a pediatric case of a pancreatic head solid pseudopapillary neoplasm (SPN) presenting with duodenal ulceration and recurrent upper GI bleeding. This case highlights pancreatic SPNs as a rare extrinsic cause of duodenal ulceration. Recurrence and progression in size and extent of a duodenal ulceration in the absence of other inciting factors should raise suspicion for an extraluminal etiology.</p>","PeriodicalId":501015,"journal":{"name":"JPGN reports","volume":"6 2","pages":"189-192"},"PeriodicalIF":0.0,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12078036/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144096749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
JPGN reportsPub Date : 2025-02-23eCollection Date: 2025-05-01DOI: 10.1002/jpr3.70008
Maria Misiou, Antonia Jeličič Kadič, Matjaž Homan
{"title":"Unusual foreign body in a teenage boy: Case presentation and review of the literature.","authors":"Maria Misiou, Antonia Jeličič Kadič, Matjaž Homan","doi":"10.1002/jpr3.70008","DOIUrl":"10.1002/jpr3.70008","url":null,"abstract":"<p><p>Foreign bodies (FBs) in the lower gastrointestinal tract are sporadically described in children. The therapeutic approach is individualized, depending on the type of FB, the location, time since insertion and the severity of bowel injuries. These FBs can be frequently removed manually or endoscopically. However, exploratory laparotomy is inevitable in unsuccessful and complicated cases. Herein we present a teenager boy with a self-inserted large perfume bottle in the sigma, and we performed the review of the published literature.</p>","PeriodicalId":501015,"journal":{"name":"JPGN reports","volume":"6 2","pages":"177-180"},"PeriodicalIF":0.0,"publicationDate":"2025-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12078062/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144096756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
JPGN reportsPub Date : 2025-02-23eCollection Date: 2025-05-01DOI: 10.1002/jpr3.12167
Jackson Fein, Amber Hildreth, Lillian J Choi, Jeannie S Huang
{"title":"Inflammatory bowel disease and hereditary hemochromatosis: A case series.","authors":"Jackson Fein, Amber Hildreth, Lillian J Choi, Jeannie S Huang","doi":"10.1002/jpr3.12167","DOIUrl":"10.1002/jpr3.12167","url":null,"abstract":"<p><p>We report a case series of three pediatric patients with inflammatory bowel disease (IBD) and variants in <i>HFE</i> which causes hereditary hemochromatosis (HH) type 1. Mice models suggest that these patients may be at increased risk for colitis and colon cancer. We detail the clinical course of these patients regarding IBD and iron overload and <i>HFE</i>-related comorbidities. We also review the known literature regarding HH and IBD overlap, HH detection and screening recommendations, HH management strategies, and iron management strategies in the context of both iron overload risk and IBD.</p>","PeriodicalId":501015,"journal":{"name":"JPGN reports","volume":"6 2","pages":"126-131"},"PeriodicalIF":0.0,"publicationDate":"2025-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12078053/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144096707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
JPGN reportsPub Date : 2025-02-19eCollection Date: 2025-05-01DOI: 10.1002/jpr3.12158
Kanya Ahuja, Shivany Pathania, Nicole Baron, Julie Khlevner, Martin Bialer, Jennifer Mait-Kaufman
{"title":"Chronic atrial and intestinal dysrhythmia: A rare genetic disorder of intestinal pseudo-obstruction.","authors":"Kanya Ahuja, Shivany Pathania, Nicole Baron, Julie Khlevner, Martin Bialer, Jennifer Mait-Kaufman","doi":"10.1002/jpr3.12158","DOIUrl":"10.1002/jpr3.12158","url":null,"abstract":"<p><p>Pediatric intestinal pseudo-obstruction (PIPO) is a rare and severe disorder of gastrointestinal (GI) motility; patients with PIPO display signs and symptoms of intestinal obstruction in the absence of occluding lesions. Chronic atrial and intestinal dysrhythmia (CAID) syndrome is an exceedingly rare autosomal recessive disorder caused by mutations in the SGO1 gene; SGO1 mutations disrupt the cohesin complex, a protein involved in chromosome organization during cell division and hence, DNA stability. CAID leads to both GI and cardiac dysfunction. This case report highlights an exceptional instance of early-onset pediatric CAID marked by recurrent pseudo-obstruction and, notably, developmental delay, which has not been previously described. The case emphasizes the importance of genetic evaluation in pediatric patients with unexplained pseudo-obstruction, and the importance of multidisciplinary management.</p>","PeriodicalId":501015,"journal":{"name":"JPGN reports","volume":"6 2","pages":"162-165"},"PeriodicalIF":0.0,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12078061/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144096690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
JPGN reportsPub Date : 2025-02-10eCollection Date: 2025-05-01DOI: 10.1002/jpr3.70004
Brad D Constant, Jeremy Adler, Benjamin D Gold, Jennifer Dotson, Jenifer R Lightdale, Frank Scott, Shehzad Saeed, Sandra Kim, Jonathan Moses, Edwin F de Zoeten, Lucia Mirea, Andrew Ritchey, Brad Pasternak
{"title":"National perspectives of barriers by insurance and pharmacy benefit managers in pediatric inflammatory bowel disease.","authors":"Brad D Constant, Jeremy Adler, Benjamin D Gold, Jennifer Dotson, Jenifer R Lightdale, Frank Scott, Shehzad Saeed, Sandra Kim, Jonathan Moses, Edwin F de Zoeten, Lucia Mirea, Andrew Ritchey, Brad Pasternak","doi":"10.1002/jpr3.70004","DOIUrl":"10.1002/jpr3.70004","url":null,"abstract":"<p><strong>Objectives: </strong>Early biologic initiation, dose optimization, and therapy modification based on disease phenotype are key to improving outcomes in pediatric inflammatory bowel disease (IBD). Enacting optimized therapy is often impeded by the lack of United States Food and Drug Administration (FDA) approval for pediatric use of newer advanced therapies or intensified dosing regimens. These barriers often result in initial payor denial of coverage and added prior authorization burden on physicians, leading to patient delays in medication initiation and therapy optimization, and development of disease-related morbidity.</p><p><strong>Methods: </strong>A sample of pediatric patients experiencing payor barriers to IBD biologic treatment, containing data on treatment delays and adverse outcomes, was obtained through a nationwide survey of pediatric gastroenterology providers via a longstanding, widely used pediatric gastroenterology Listserv (housed at University of Vermont) from January 2023 to August 2023.</p><p><strong>Results: </strong>Providers across the United States reported information for 113 patients experiencing payor barriers for biologics IBD treatment. Ultimately, 77% of initial denials were approved. The median time to receiving medication was 18 days, with administrative time (prior authorization and appeal) requiring a median of 180 min. More than half (60%) of patients experienced adverse outcomes or worsened quality of life due to delays in treatment, including 21% of patients who were hospitalized.</p><p><strong>Conclusions: </strong>These findings highlight the detrimental impact of payor barriers to treatment for children with IBD. Reforms that minimize delays in care and provider administrative burden are imperative to ensure that children receive timely evidence-based treatment that improves disease outcomes and prevents adverse events.</p>","PeriodicalId":501015,"journal":{"name":"JPGN reports","volume":"6 2","pages":"80-90"},"PeriodicalIF":0.0,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12078066/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144096711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}