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Not all pediatric intestinal polyps are alike

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Abstract
Background/Aims : In childhood, clinical presentation of intestinal polyps is variable. Painless rectal red blood loss is the most common presenting sign. Most polyps are sporadic, isolated and benign. However, it is important to correctly identity exceptions. Hare inherited polyposis syndromes need to be recognized because of their increased risk of intestinal and extra-intestinal malignancies. Furthermore, a correct diagnosis and treatment of rare gastro-intestinal malignancies is crucial. Methods : Between 2016 and 2018 we encountered 4 different types of intestinal polyps. A database search was performed and patient tiles were checked for clinical manifestations and histopathology. Literature was searched to recapitulate red flags for these syndromes, probability of underlying genetic disorders and diagnostic criteria. Results : Between 2016 and 2018, 28 patients presented at the Ghent University Hospital with 30 juvenile polyps. Furthermore, we diagnosed juvenile polyposis syndrome, Li Fraumeni syndrome and familial adenomatous polyposis (FAP) in 1 patient each, whilst 2 FAP patients were in follow-up. Each of these diagnoses has a different lifetime risk of (extra)-intestinal malignancy and requires a different approach and follow-up. Histopathology and genetic testing play an important role in identifying these syndromes in pediatric patients. Conclusion : Although most intestinal polyps in childhood are benign juvenile polyps that require no follow-up, rare inherited syndromes should be considered and correctly diagnosed since adequate follow-up is necessary to reduce morbidity and mortality from both gastrointestinal and extraintestinal complications and malignancies.
Keywords
juvenile polyps, polyposis syndrome, FAP, Li Fraumeni, cancer, predisposition

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MLA
Vermeulen, Drieke, et al. “Not All Pediatric Intestinal Polyps Are Alike.” ACTA GASTRO-ENTEROLOGICA BELGICA, vol. 83, no. 3, 2020, pp. 393–97.
APA
Vermeulen, D., Van Winckel, M., Vande Velde, S., De Bruyne, R., Van Biervliet, S., De Moerloose, B., … Van de Putte, D. (2020). Not all pediatric intestinal polyps are alike. ACTA GASTRO-ENTEROLOGICA BELGICA, 83(3), 393–397.
Chicago author-date
Vermeulen, Drieke, Myriam Van Winckel, Saskia Vande Velde, Ruth De Bruyne, Stephanie Van Biervliet, Barbara De Moerloose, Lucas Matthyssens, Katrien Van Renterghem, and Dirk Van de Putte. 2020. “Not All Pediatric Intestinal Polyps Are Alike.” ACTA GASTRO-ENTEROLOGICA BELGICA 83 (3): 393–97.
Chicago author-date (all authors)
Vermeulen, Drieke, Myriam Van Winckel, Saskia Vande Velde, Ruth De Bruyne, Stephanie Van Biervliet, Barbara De Moerloose, Lucas Matthyssens, Katrien Van Renterghem, and Dirk Van de Putte. 2020. “Not All Pediatric Intestinal Polyps Are Alike.” ACTA GASTRO-ENTEROLOGICA BELGICA 83 (3): 393–397.
Vancouver
1.
Vermeulen D, Van Winckel M, Vande Velde S, De Bruyne R, Van Biervliet S, De Moerloose B, et al. Not all pediatric intestinal polyps are alike. ACTA GASTRO-ENTEROLOGICA BELGICA. 2020;83(3):393–7.
IEEE
[1]
D. Vermeulen et al., “Not all pediatric intestinal polyps are alike,” ACTA GASTRO-ENTEROLOGICA BELGICA, vol. 83, no. 3, pp. 393–397, 2020.
@article{8682635,
  abstract     = {{Background/Aims : In childhood, clinical presentation of intestinal polyps is variable. Painless rectal red blood loss is the most common presenting sign. Most polyps are sporadic, isolated and benign. However, it is important to correctly identity exceptions. Hare inherited polyposis syndromes need to be recognized because of their increased risk of intestinal and extra-intestinal malignancies. Furthermore, a correct diagnosis and treatment of rare gastro-intestinal malignancies is crucial.

Methods : Between 2016 and 2018 we encountered 4 different types of intestinal polyps. A database search was performed and patient tiles were checked for clinical manifestations and histopathology. Literature was searched to recapitulate red flags for these syndromes, probability of underlying genetic disorders and diagnostic criteria.

Results : Between 2016 and 2018, 28 patients presented at the Ghent University Hospital with 30 juvenile polyps. Furthermore, we diagnosed juvenile polyposis syndrome, Li Fraumeni syndrome and familial adenomatous polyposis (FAP) in 1 patient each, whilst 2 FAP patients were in follow-up. Each of these diagnoses has a different lifetime risk of (extra)-intestinal malignancy and requires a different approach and follow-up. Histopathology and genetic testing play an important role in identifying these syndromes in pediatric patients.

Conclusion : Although most intestinal polyps in childhood are benign juvenile polyps that require no follow-up, rare inherited syndromes should be considered and correctly diagnosed since adequate follow-up is necessary to reduce morbidity and mortality from both gastrointestinal and extraintestinal complications and malignancies.}},
  author       = {{Vermeulen, Drieke and Van Winckel, Myriam and Vande Velde, Saskia and De Bruyne, Ruth and Van Biervliet, Stephanie and De Moerloose, Barbara and Matthyssens, Lucas and Van Renterghem, Katrien and Van de Putte, Dirk}},
  issn         = {{1784-3227}},
  journal      = {{ACTA GASTRO-ENTEROLOGICA BELGICA}},
  keywords     = {{juvenile polyps,polyposis syndrome,FAP,Li Fraumeni,cancer,predisposition}},
  language     = {{eng}},
  number       = {{3}},
  pages        = {{393--397}},
  title        = {{Not all pediatric intestinal polyps are alike}},
  url          = {{https://www.ageb.be/ageb-journal/ageb-volume/ageb-article/1812/Not%20all%20pediatric%20intestinal%20polyps%20are%20alike/}},
  volume       = {{83}},
  year         = {{2020}},
}

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