Table of Contents

HK J Paediatr (New Series)
Vol 22. No. 4, 2017

HK J Paediatr (New Series) 2017;22:199-203

Original Article

The Preliminary Investigation of Faecal Microbiota Transplantation for Paediatric Recurrent Chronic Bowel Diseases and Literature Review
糞便菌群移植治療兒童反覆慢性腸道疾病的初步研究和文獻綜述

YH Fang, J Chen, JD Yu, YY Luo, JG Lou


Abstract

Background: Faecal microbiota transplantation (FMT) is a potential therapeutic method to treat intestinal diseases with faecal dysbiosis. FMT has demonstrated effectiveness for recurrent Clostridium difficile infection (CDI), meanwhile it also showed potential therapeutic effect for some inflammatory bowel disease (IBD) patients. Methods: There were five patients, from 1Y6M to 11 years old. Two patients were diagnosed very early onset Crohn's disease (CD), two patients were ulcerative colitis (UC) and one patient was pseudomembranous colitis. They underwent FMT therapy by nasal jejunal tube or colonoscopy, and were followed up every two to four weeks after FMT. Results: One UC patient and the pseudomembranous colitis patient achieved partial remission after FMT. However, both of the patients' symptoms relapsed six to eight weeks after FMT. Two CD patients and one UC patient did not respond to FMT therapy. All of the IBD patients had moderate to severe disease active index before FMT. For adverse effects: four of the patients had fever after FMT. Other adverse events included abdominal pain, abdominal uncomfortable,they were mild and self-limiting. Conclusions: FMT had limited effect for very early onset CD and UC patients in our preliminary clinical experience. The incidence of adverse effects of FMT was much higher than reported.

背景:糞便菌群移植(FMT)是治療伴有糞便菌群失調的小腸疾病的一種有希望的治療方法。對反覆艱難梭菌感染(CDI),FMT有效,而且對部份炎症性腸道疾病(IBD)病人可能有效。方法:病人5名,1歲6月至11歲。診斷早發性克隆恩氏病(CD) 二例,潰瘍性結腸炎(UC)二例,假膜性結腸炎一例。用鼻空腸管或結腸鏡進行 FMT治療,病人治療後每2至4週覆診追蹤。結果:FMT後一例UC和一例假膜性腸炎病人達到部份緩解。然而,治療後6-8週均症狀復發。二例CD和一例UC病人對FMT治療無效。FMT治療前,全部IBD病人均有中等至重度的疾病活躍指數。關於副作用,FMT後發熱有四例。其他副作用包括腹痛和腹部不適,均為輕度和自限性。結論:在作者初步臨床經驗中,FMT對早發性CD和UC療效有限。FMT副作用的發病率大大高於以往所報告的數據。

Keyword : Crohn's disease; Faecal microbiota transplantation; Paediatrics; Pseudomembranous colitis; Ulcerative colitis

關鍵詞:克隆恩氏病、糞便菌群移植、兒科、假膜性腸炎、潰瘍性結腸炎

 
 

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