JPGN Journal Club October 2023: Budd-Chiari Syndrome, Pediatric Intestinal Failure, and Thiopurine Therapy in Ulcerative Colitis

Dr Alex Knisely today in JPGN Journal Club is – as usual ! -- speaking with Dr Andreas Jenke, who for discussion has chosen the three articles Budd-Chiari Syndrome – A Single-Centre Experience from the United Kingdom, contributed by the Birmingham paediatric team ; Body Composition and Physical Activity in Pediatric Intestinal Failure, from London’s Great Ormond Street ; and Thiopurines Maintenance Therapy in Children with Ulcerative Colitis, the work of several medical centres in Israel. Budd-Chiari syndrome in children . . . a quarter of a century and 25 cases, but as soon as you think “I’ll never see that” you’ll be called to Accident & Emergency for your first patient with, yes, you guessed it. Good to have this review to read on your mobile telephone as you walk down to A&E. Our London mates remind us that the body-composition shifts-to-fat so usual in intestinal failure do not go away on their own once parenteral feeding no longer is required : One take-home message may be that children who never could develop a habit of exercise when they were catheter-tethered need to be prodded into physical activity (and their parents to learn to see the children as suited for physical activity). Finally, from Israel, a confirmation that the old ways may still be the best ways : Whilst the tendency nowadays is to carpet-bomb ulcerative colitis into submission, calling out the F16s (uhm, those are the biological agents) at presentation, traditional tactics of ground warfare (those are the thiopurines) both regain and hold territory very adequately indeed – less expensively and with far greater knowledge of What To Expect. Happy listening – and reading !