الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Inflammatory bowel diseases (IBDs), including ulcerative colitis (UC) and Crohn’s disease (CD), the chronic relapsing immune-mediated disorders of the gastrointestinal tract, that were usually considered diseases of young adulthood, recently became more common among pediatric populations that most pediatricians encounter children with IBD in their general practice. This aroused attention towards a better understanding of the disease nature and the possible factors influencing the course of the disease.
Owing to the growing interest in investigating the immunomodulatory effects of vitamin D on autoimmune diseases, including IBD, over the recent years, altogether with the high prevalence of vitamin D deficiency reported among IBD patients in many studies, interestingly, it was hypothesized that vitamin D deficiency has a possible pathogenic influence on the pathophysiology of IBD. Also, several clinical studies have pointed to the critical role of vitamin D in ameliorating the disease activity.
In context, the aim of our study was to determine the vitamin D status of children with IBD in a flare and to evaluate the correlation between serum level of 25-hydroxy vitamin D and the disease activity in these children.
To achieve this goal, the present study was carried out on a total of 35 patients below 18 years with a confirmed diagnosis of active IBD, scheduled for colonoscopy at Alexandria University Children’s Hospital. Of those 35, 19 cases were previously diagnosed as IBD and were indicated for follow up colonoscopy due to relapsing symptoms, while 16 cases were chosen upon suggestive colonoscopic features and later confirmed by histopathological and/or radiological criteria. A control group of 35 age and sex-matched healthy children were included.
Statistical analysis of data obtained from the present study showed the following results
1- Males account for 57% of the IBD children in our series, more CD (n=19) cases than UC (n=16) were encountered, with a mean age of 8.5 years at diagnosis, moreover, 23% were diagnosed before age of 5 years.
2- BMI was significantly lower in IBD cases than healthy controls (p=0.001), denoting that the weight and height of patients were affected by the disease process.
3- Abdominal pain was the most common clinical manifestation in the studied IBD cases (91.4%), followed by bleeding per rectum (82.9%) then diarrhea (68.6%).
4- Bleeding per rectum was significantly predominant in UC cases (100% versus 68.4%) (p=0.022), while extraintestinal manifestations were significantly more pronounced among CD cases (63.2% versus 25%) (p=0.024). Weight loss and perineal diseases were more common in CD cases.
5- Family history was positive in 20% of the cases, with no significant difference detected between the two subgroups (26.3% for CD versus 12.5% for UC).