Publication

Towards personalized medicine in pediatric inflammatory bowel disease

Haisma, S., 2019, [Groningen]: Rijksuniversiteit Groningen. 243 p.

Research output: ThesisThesis fully internal (DIV)Academic

Copy link to clipboard

Documents

  • Title and contents

    Final publisher's version, 145 KB, PDF document

  • Chapter 1

    Final publisher's version, 268 KB, PDF document

  • Chapter 2

    Final publisher's version, 244 KB, PDF document

    Embargo ends: 09/10/2020

    Request copy

  • Chapter 3

    Final publisher's version, 433 KB, PDF document

  • Chapter 4

    Final publisher's version, 164 KB, PDF document

  • Chapter 5

    Final publisher's version, 112 KB, PDF document

  • Chapter 6

    Final publisher's version, 272 KB, PDF document

  • Chapter 7

    Final publisher's version, 197 KB, PDF document

  • Chapter 8

    Final publisher's version, 236 KB, PDF document

    Embargo ends: 09/10/2020

    Request copy

  • Chapter 9

    Final publisher's version, 185 KB, PDF document

  • Chapter 10

    Final publisher's version, 87 KB, PDF document

  • Complete thesis

    Final publisher's version, 1 MB, PDF document

    Embargo ends: 09/10/2020

    Request copy

  • Propositions

    Final publisher's version, 31 KB, PDF document

DOI

In this thesis we aimed to contribute to the further development of personalized medicine in children and adolescents with inflammatory bowel disease (IBD). We focused on two different aspects: (1) the potential role of periodically measuring stool calprotectin levels, to see whether calprotectin can also be used to monitor response to treatment; and (2) profiling patients with pediatric-onset primary sclerosing cholangitis (PSC), a rare but severe hepatobiliairy disease that is strongly associated with IBD.
Using periodically measured stool calprotectin levels to monitor response-to-treatment is a relatively new application of this diagnostic test. In patients receiving remission-induction therapy, a shift of calprotectin concentrations into the target range appears to be a good surrogate marker for mucosal healing. Reaching the target calprotectin range within 3 months after starting the treatment predicts a favourable disease course in children with Crohn’s disease. Vice versa, patients who fail to reach target calprotectin levels within 3 months after conventional induction therapy may be entitled to step-up to a more aggressive treatment.
Until recently, childhood-onset PSC was believed to present with milder disease and a more favourable outcome than adult-onset PSC. By evaluating time-to-complication in children with PSC up until adulthood, we showed that paediatric- and adult-onset PSC run a similar progressive disease course. Furthermore, examination of the genetic material (DNA) of children with PSC and their biological parents revealed multiple rare candidate disease-causing variants.
Original languageEnglish
QualificationDoctor of Philosophy
Awarding Institution
Supervisors/Advisors
Award date9-Oct-2019
Place of Publication[Groningen]
Publisher
Print ISBNs978-94-6375-552-8
Electronic ISBNs978-94-6375-553-5
Publication statusPublished - 2019

Download statistics

No data available

ID: 96888808