Intestinal Research

Takashi Ishige

3 Articles

Infection

Whipple disease mimicking inflammatory bowel disease: Maiko Tatsuki, Takashi Ishige, Yoshiko Igarashi, Reiko Hatori, Akira Hokama, Junko Hirato, Aleixo Muise, Takumi Takizawa, Hirokazu Arakawa; Intest Res 2021;19(1):119-125. Published online July 3, 2020; DOI: https://doi.org/10.5217/ir.2019.09177

Whipple disease is a systemic chronic infection caused by Tropheryma whipplei. Although chronic diarrhea is a common gastrointestinal symptom, diagnosis is often difficult because there are no specific endoscopic findings, and the pathogen is not detectable by stool culture. We present a female patient with Whipple disease who developed chronic bloody diarrhea and growth retardation at the age of 4 years. Colonoscopy showed a mildly edematous terminal ileum and marked erythema without vascular patterns throughout the sigmoid colon and rectum. Subsequently, a primary diagnosis of ulcerative colitis was made. Histopathological analysis of the terminal ileum showed the presence of foamy macrophages filled with periodic acidSchiff-positive particles. Polymerase chain reaction using DNA from a terminal ileum biopsy sample amplified a fragment of 16S rRNA from T. whipplei. Antibiotic treatment relieved the patient’s symptoms. There was no evidence of immunodeficiency in the present case. Since Whipple disease worsens after anti-tumor necrosis factor inhibitor therapy, considering this infection in the differential diagnosis may be important in patients with inflammatory bowel disease, especially before initiation of immunotherapy.

Citations

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Through the Looking Glass: A Child With Arthralgia, Malaise and Weight Loss
Aline R. Verhage, Iris D. Nagtegaal, Cathelijne van der Feen, Tom F.W. Wolfs
Pediatric Infectious Disease Journal.2023; 42(7): 629. CrossRef
Enfermedad de Whipple: revisión sistemática de la literatura
Ledmar Jovanny Vargas Rodriguez, Jeinny Lucero Ruiz Muñoz, Paola Andrea Bolivar Córdoba, Monica Dayana Romero Cely, Ervirson Jair Cañon Abril, Zulma Marisol Suarez Correa, María Angélica Mendoza Cáceres
Revista colombiana de Gastroenterología.2023; 38(1): 35. CrossRef
Whipple’s Disease with Colonic Involvement: A Rare Endoscopic Documentation
Verónica Gamelas, Ines Canha, João Pimentel, Sara Santos, Verónica Borges, Carlos Bernardes
GE - Portuguese Journal of Gastroenterology.2022; 29(6): 436. CrossRef
Whipple’s disease with normal duodenal histology diagnosed by ileal biopsy using balloon endoscopy
Hideki Mori, Chiaki Yakabi, Kiwamu Yonahara, Kazunao Hamahiga, Miyu Yoshimura, Masaki Sakihara, Kenji Ishihara, Kinya Azama, Takayuki Chinen, Osamu Zaha
Clinical Journal of Gastroenterology.2022; 15(4): 702. CrossRef

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Inflammatory bowel diseases

Phenotypic characteristics of pediatric inflammatory bowel disease in Japan: results from a multicenter registry: Katsuhiro Arai, Reiko Kunisaki, Fumihiko Kakuta, Shin-ichiro Hagiwara, Takatsugu Murakoshi, Tadahiro Yanagi, Toshiaki Shimizu, Sawako Kato, Takashi Ishige, Tomoki Aomatsu, Mikihiro Inoue, Takeshi Saito, Itaru Iwama, Hisashi Kawashima, Hideki Kumagai, Hitoshi Tajiri, Naomi Iwata, Takahiro Mochizuki, Atsuko Noguchi, Toshihiko Kashiwabara, Hirotaka Shimizu, Yasuo Suzuki, Yuri Hirano, Takeo Fujiwara; Intest Res 2020;18(4):412-420. Published online August 18, 2020; DOI: https://doi.org/10.5217/ir.2019.00130

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Background/Aims
There are few published registry studies from Asia on pediatric inflammatory bowel disease (IBD). Registry network data enable comparisons among ethnic groups. This study examined the characteristics of IBD in Japanese children and compared them with those in European children.
Methods
This was a cross-sectional multicenter registry study of newly diagnosed Japanese pediatric IBD patients. The Paris classification was used to categorize IBD features, and results were compared with published EUROKIDS data.
Results
A total of 265 pediatric IBD patients were initially registered, with 22 later excluded for having incomplete demographic data. For the analysis, 91 Crohn’s disease (CD), 146 ulcerative colitis (UC), and 6 IBD-unclassified cases were eligible. For age at diagnosis, 20.9% of CD, 21.9% of UC, and 83.3% of IBD-unclassified cases were diagnosed before age 10 years. For CD location, 18.7%, 13.2%, 64.8%, 47.3%, and 20.9% were classified as involving L1 (ileocecum), L2 (colon), L3 (ileocolon), L4a (esophagus/stomach/duodenum), and L4b (jejunum/proximal ileum), respectively. For UC extent, 76% were classified as E4 (pancolitis). For CD behavior, B1 (non-stricturing/non-penetrating), B2 (stricturing), B3 (penetrating), and B2B3 were seen in 83.5%, 11.0%, 3.3%, and 2.2%, respectively. A comparison between Japanese and European children showed less L2 involvement (13.2% vs. 27.3%, P< 0.01) but more L4a (47.3% vs. 29.6%, P< 0.01) and L3 (64.8% vs. 52.7%, P< 0.05) involvement in Japanese CD children. Pediatric perianal CD was more prevalent in Japanese children (34.1% vs. 9.7%, P< 0.01).
Conclusions
Upper gastrointestinal and perianal CD lesions are more common in Japanese children than in European children.

Citations

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Journal of Gastroenterology and Hepatology.2025; 40(1): 123. CrossRef
Outcome of pediatric inflammatory bowel disease in Asian children: a multinational 1-year follow-up study
Pornthep Tanpowpong, Suporn Treepongkaruna, James Guoxian Huang, Kee Seang Chew, Karen Sophia Calixto Mercado, Almida Reodica, Shaman Rajindrajith, Wathsala Hathagoda, Yoko Kin Yoke Wong, Way Seah Lee, Marion Margaret Aw
Clinical and Experimental Pediatrics.2025; 68(3): 247. CrossRef
Prognosis of pediatric ulcerative colitis after infliximab failure: A multicenter registry‐based cohort study
Ryusuke Nambu, Takahiro Kudo, Nao Tachibana, Hirotaka Shimizu, Tatsuki Mizuochi, Sawako Kato, Mikihiro Inoue, Hideki Kumagai, Takashi Ishige, Reiko Kunisaki, Atsuko Noguchi, Toshifumi Yodoshi, Shin‐Ichiro Hagiwara, Shigeo Nishimata, Fumihiko Kakuta, Takes
Journal of Gastroenterology and Hepatology.2024; 39(2): 312. CrossRef
Prevalence of Inflammatory Bowel Disease Unclassified, as Estimated Using the Revised Porto Criteria, among Korean Pediatric Patients with Inflammatory Bowel Disease
Sung Hee Lee, Minsoo Shin, Seo Hee Kim, Seong Pyo Kim, Hyung-Jin Yoon, Yangsoon Park, Jaemoon Koh, Seak Hee Oh, Jae Sung Ko, Jin Soo Moon, Kyung Mo Kim
Pediatric Gastroenterology, Hepatology & Nutrition.2024; 27(4): 206. CrossRef
Clinical Efficacy and Future Application of Indigo Naturalis in the Treatment of Ulcerative colitis
Dianzhen Wu, Qi Huang, Yingbi Xu, Ruiyi Cao, Ming Yang, Jin Xie, Dingkun Zhang
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Yoshikazu Miura, Shin‐ichiro Hagiwara, Keinosuke Hizuka, Ryutaro Saura, Ayaha Hata, Takatoshi Maeyama, Yuri Etani
Pediatrics International.2024;[Epub] CrossRef
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Eliana Fanous, Tal Marshanski, Noa Tal, Manar Matar, Yael Weintraub, Raanan Shamir, Dror S. Shouval
Journal of Pediatric Gastroenterology & Nutrition.2023; 77(3): 358. CrossRef
Caracterización clínica y terapéutica de una cohorte multicéntrica de pacientes con enfermedad inflamatoria intestinal en Colombia
Viviana Parra-Izquierdo, Cristian Flórez Sarmiento, Juan Sebastián Frías-Ordoñez, Melquicedec Vargas, Joshua Kock, Natalia Lozano Escobar, Juan Ricardo Márquez
Gastroenterología y Hepatología.2023; 46(8): 585. CrossRef
Potential of Gut Microbe-Derived Extracellular Vesicles to Differentiate Inflammatory Bowel Disease Patients from Healthy Controls
Min Heo, Young Soo Park, Hyuk Yoon, Nam-Eun Kim, Kangjin Kim, Cheol Min Shin, Nayoung Kim, Dong Ho Lee
Gut and Liver.2023; 17(1): 108. CrossRef
Medical management of pediatric inflammatory bowel disease in the Asia‐Pacific region: A position paper by the Asian Pan‐Pacific Society for Pediatric Gastroenterology, Hepatology, and Nutrition (APPSPGHAN) PIBD Working Group
Way Seah Lee, Katsuhiro Arai, George Alex, Suporn Treepongkaruna, Kyung Mo Kim, Chee Liang Choong, Karen S. C. Mercado, Andy Darma, Anshu Srivastava, Marion M. Aw
Journal of Gastroenterology and Hepatology.2023; 38(4): 523. CrossRef
Clinical outcome of ulcerative colitis with severe onset in children: a multicenter prospective cohort study
Ryusuke Nambu, Katsuhiro Arai, Takahiro Kudo, Takatsugu Murakoshi, Reiko Kunisaki, Tatsuki Mizuochi, Sawako Kato, Hideki Kumagai, Mikihiro Inoue, Takashi Ishige, Takeshi Saito, Atsuko Noguchi, Toshifumi Yodoshi, Shin-Ichiro Hagiwara, Naomi Iwata, Shigeo N
Journal of Gastroenterology.2023; 58(5): 472. CrossRef
Mucosal immune systems of pediatric inflammatory bowel disease: A review
Takahiro Kudo, Toshiaki Shimizu
Pediatrics International.2023;[Epub] CrossRef
Clinical and therapeutic characterisation of a multicentre cohort of patients with inflammatory bowel disease in Colombia
Viviana Parra-Izquierdo, Cristian Flórez Sarmiento, Juan Sebastián Frías-Ordoñez, Melquicedec Vargas, Joshua Kock, Natalia Lozano Escobar, Juan Ricardo Márquez
Gastroenterología y Hepatología (English Edition).2023; 46(8): 585. CrossRef
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Long-term Disease Course of Crohn’s Disease: Changes in Disease Location, Phenotype, Activities, and Predictive Factors
Choong Wui Cho, Myung-Won You, Chi Hyuk Oh, Chang Kyun Lee, Sung Kyoung Moon
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Katsuyoshi Matsuoka, Katsumasa Nagano, Shinya Nagasaki, Yoko Murata, Tadakazu Hisamatsu
BMJ Open.2022; 12(5): e060081. CrossRef
Personalized medicine in inflammatory bowel disease: Perspectives on Asia
Su Hyun Park, Sang Hyoung Park
Journal of Gastroenterology and Hepatology.2022; 37(8): 1434. CrossRef
Phenotypic Pattern of Early Versus Later-Onset Pediatric Inflammatory Bowel Disease in a Eurasian Country
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Epidemiology and diagnosis of inflammatory bowel diseases
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Journal of the Korean Medical Association.2021; 64(9): 579. CrossRef
Very early onset inflammatory bowel disease in a South Asian country where inflammatory bowel disease is emerging: a distinct clinical phenotype from later onset disease
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Pediatric Gastroenterology, Hepatology & Nutrition.2021; 24(6): 564. CrossRef

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Japanese physicians' attitudes towards enteral nutrition treatment for pediatric patients with Crohn's disease: a questionnaire survey: Takashi Ishige, Takeshi Tomomasa, Hitoshi Tajiri, Atsushi Yoden; Intest Res 2017;15(3):345-351. Published online June 12, 2017; DOI: https://doi.org/10.5217/ir.2017.15.3.345

Abstract PDF PubReader ePub

<b>Background/Aims</b><br/>

Enteral nutrition (EN) is recommended for the treatment of pediatric Crohn's disease (CD) in Japan. However, the indications and treatment protocols for EN vary among hospitals. In the present study, we aimed to determine how EN was administered to pediatric patients and whether physicians followed treatment guidelines in their practices.

Methods

Two types of questionnaires were administered to 32 physicians who were involved in the treatment of pediatric CD. The consensus questionnaire evaluated the physicians' attitudes towards EN, whereas the efficacy questionnaire collected data on patients with CD, aged <17 years, who had undergone induction therapy between 2006 and 2011.

Results

A total of 23 physicians responded to the questionnaires. The results of the consensus questionnaire indicated that 82% and 59% of study participants recommended EN treatment for all newly diagnosed pediatric patients with CD and all relapsed patients, respectively. Exclusive EN (EEN) and elemental formula were recommended by 84% and 85% of physicians, respectively. The efficacy questionnaire revealed that 57 of the 58 patients received EN. Elemental formula was used in 39 of 40 patients who were treated with EEN. Of these 40 patients, 27 were treated with EEN alone; of these, 22 (81%) achieved remission without any other treatment. The mean duration of EEN was 15.9 days.

Conclusions

EN is widely recommended by physicians treating pediatric CD in Japan. In contrast to Western countries, clinicians used elemental formula more often and with a shorter EEN treatment duration.

Citations

Citations to this article as recorded by

A kizárólagos enteralis táplálás hazai gyakorlata gyermekkori Crohn-betegségben
Kriszta Katinka Boros, Veronika Kovács, Éva Nemes, Orsolya Kadenczki, Gábor Veres, Katalin Eszter Müller
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Enteral Nutrition Prescription in Children and Adults with Inflammatory Bowel Diseases: Gaps in Current Gastroenterology Practice in Saudi Arabia
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Implementation of exclusive enteral nutrition in pediatric patients with Crohn’s disease—results of a survey of CEDATA-GPGE reporting centers
Sarah Peters, Serdar Cantez, Jan De Laffolie
Molecular and Cellular Pediatrics.2022;[Epub] CrossRef
Global attitudes on and the status of enteral nutrition therapy for pediatric inflammatory bowel disease
Juan Luo, Yong-Mei Xie, Mei Wu, Jin-Gui Zhao, Liang-Liang Hu
Frontiers in Medicine.2022;[Epub] CrossRef
Elemental Diet Enriched with Amino Acids Alleviates Mucosal Inflammatory Response and Prevents Colonic Epithelial Barrier Dysfunction in Mice with DSS-Induced Chronic Colitis
Di Guo, Jun Yang, Fangmei Ling, Lei Tu, Junrong Li, Yidong Chen, Kaifang Zou, Liangru Zhu, Xiaohua Hou
Journal of Immunology Research.2020; 2020: 1. CrossRef
Exclusive enteral nutrition in children with inflammatory bowel disease: Physician perspectives and practice
Shaun S C Ho, Andrew S Day
JGH Open.2019; 3(2): 148. CrossRef
Global Variation in Use of Enteral Nutrition for Pediatric Crohn Disease
Morgan Lawley, Jessica W. Wu, Victor M. Navas‐López, Hien Q. Huynh, Matthew W. Carroll, Min Chen, Pavel Medvedev, Andrew S. Day, Séamus Hussey, Rotem Sigall‐Boneh, Arie Levine, Eytan Wine
Journal of Pediatric Gastroenterology and Nutrition.2018;[Epub] CrossRef
Living on Liquids: Surviving and Thriving on Exclusive Enteral Nutrition
Kelly Issokson
American Journal of Gastroenterology.2017; 112(10): 1491. CrossRef

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