Hentz, Roland

Abstract Objectives Microscopic colitis (MC) is an inflammatory disease of the large intestine characterized by chronic diarrhea, normal‐appearing colonic mucosa on endoscopy, and abnormal inflammatory histopathology. While it is a common cause of chronic diarrhea in adults, MC is infrequently reported in children, and data on its presentation, treatment, and outcomes remain limited. This study aimed to analyze single‐center experience and conduct a literature review on pediatric MC. Methods A retrospective review of the Mayo Clinic electronic health records from 2013 to 2024 was performed. Children (≤18 years) diagnosed with MC were included. Demographics, clinical presentation, treatment, and outcomes were collected. A systematic review of pediatric MC literature was completed. Results MC was diagnosed in 42 children (median age 12.5 years; Q1–Q3 7.25–14.75), with 28 (67%) females. Systematic review identified 29 studies with 258 children with MC (mean age 10 years, standard deviation [SD] 4.9). At Mayo Clinic, treatment varied among providers, and budesonide as monotherapy or in combination was most effective. In the literature, the most commonly used treatments included 5‐aminosalicylates (5‐ASA, 36%) and budesonide (31.5%). Combination therapy with budesonide plus a biologic or mesalamine appeared to be the most effective therapy, followed by budesonide monotherapy and corticosteroids. Mucosal remission rate was highest with corticosteroids, followed by budesonide. Mean recurrence rate across all treatments was 69%. Biologics (vedolizumab, infliximab) and bismuth showed the lowest recurrence rates. Conclusion Budesonide, either alone or in combination, appears to be most commonly used and effective in treating pediatric MC, but recurrence rates remain high after therapy discontinuation.

ABSTRACT Objectives To evaluate the impact of semaglutide on body mass index (BMI) and cardiometabolic markers in adolescents with obesity and genetic variants associated with monogenic or syndromic obesity. Methods A retrospective chart review was conducted in adolescents with severe obesity who underwent multigene panel testing and were treated with semaglutide. Results Twenty‐seven adolescents (mean age 15 ± 1.9 years); BMI % of the 95th percentile 158 ± 29; (70% White) were treated with semaglutide for a mean of 10 ± 4.7 months. Participants were classified into three groups: (1) Dominant or Known Risk Variants ( n = 7); (2) Carriers of Rare Variants in Recessive Genes ( n = 10); and (3) Negative or Unmatched Genetic Findings ( n = 10). All groups showed reductions in BMI, which was not different between the groups. Adolescents with dominant or known risk variants experienced a significant decrease in BMI % of the 95th percentile (−17, (IQR −26 to −10) p = 0.022) and in BMI by −9.4% ± 7% ( p = 0.035). Significant improvements in median non‐HDL cholesterol (−16 mg/dL), total cholesterol (−15 mg/dL), and HbA1c (−0.3%) were noted in children with dominant or known risk variants ( p = 0.036). Conclusions Semaglutide was associated with significant reductions in BMI and cardiometabolic markers in adolescents (majority White) with dominant or known risk variants for monogenic obesity.