Problems of Radiation Medicine and Radiobiology

PECULIARITIES OF GASTROINTESTINAL DISEASE CONCOMITANT TO HEART CONNECTIVE TISSUE DYSPLASIA IN CHILDREN BORN FROM PERSONS EXPOSED TO IONIZING RADIATION IN CHILDHOOD AFTER THE CHNPP ACCIDENT

V. G. Kondrashova, I. Ye. Kolpakov, V. Yu. Vdovenko, V. M. Gromadska, V. G. Boyarskiy,
T. V. Grytsenko, O. Ya. Pleskach, Ye. I. Stepanova
State Institution “National Research Center for Radiation Medicine of the National Academy of MedicalSciences of Ukraine”, Melnykov str., 53, Kyiv, 04050, Ukraine

Study objective. The study examined the peculiarities of upper gastrointestinal tract diseases in children suffering from a syndrome of heart connective tissue dysplasia (HCTDS) born from persons exposed to ionizing radiation in a childhood after the ChNPP accident.
Materials and methods. The study included 120 children suffering from HCTDS (group I) and 75 persons having no signs of the syndrome (Group II). Diagnosis of HCTDS was obtained from echocardiography in B- and M-modes and Doppler echocardiography. Esophagogastroduodenoscopy was performed using a flexible endoscope “OLYMPUS” model GIF-P3. Abdominal diagnostic ultrasound was used to assay the structure of abdominal parenchymal viscera.
Results. Upper gastrointestinal tract diseases (UGITD) manifest earlier in children suffering the HCTDS (beginning from a preschool age). Along with age the systemic pattern of organ and system injury becomes evident i.e. there were 6.8 clinical/nosological entities per one child in Group I and 4.9 in Group II. Clinical presentation of chronic UGITD diseases in children suffering concomitant HCTDS were characterized by more frequent exacerbation after the psychoemotional and physical strain, more frequent intestinal motor dysfunction, nervous system disorders (80 %),
and chronic infections (62.2 %). Endoscopic pattern of chronic UGITD with concomitant HCTDS featured a combination of mucosal inflammation (a range of various forms of esophagitis, erythematous and hypertrophic gastroduodenopathy) with abnormal gastrointestinal motor function i.e. gastroesophageal and duodenogastric reflux (73.34 %). Destructive lesions at most of duodenal zone were found in 20 %.
Conclusions. UGITD namely chronic gastroduodenitis with typically concomitant involvement of several parts of digestive tract are most prevalent within all digestive system diseases in remote period upon the Chornobyl disaster in children born from persons exposed to ionizing radiation in a childhood. Presentation of UGITD occurs earlier in children suffering HCTDS with evident systemic pattern of organ and system injury along with an age. Refluxes of various nature and localization are the leading factors for UGITD onset in children suffering HCTDS. Thus a range of multidirectional tools of reflux disease prophylaxis is required for inclusion to the disease management.

Key words: connective tissue dysplasia, gastrointestinal tract diseases, children, Chornobyl accident.

Problems of radiation medicine and radiobiology. 2014;19:287-297.