Abstracts / Digestive and Liver Disease 46 (2014) e71–e84 FATA JUNIOR GASTRO SIGENP: A FIRST ITALIAN SURVEY ON NONSTEROIDAL ANTI-INFLAMMATORY DRUGS (NSAID) AND UPPER GASTROINTESTINAL BLEEDING IN CHILDREN Sabrina Cardile 1,∗ , Arrigo Barabino 2 , Paolo Gandullia 2 , Salvatore Cucchiara 3 , Giovanni Di Nardo 3 , Luigi Dall’Oglio 4 , Francesca Rea 4 , Gian Luigi de’Angelis 5 , Barbara Bizzarri 5 , Graziella Guariso 6 , Enzo Masci 7 , Annamaria Staiano 8 , Erasmo Miele 8 , Massimo Martinelli 8 , Antonio Tomaino 9 , Claudio Romano 1 1 Sezione di Gastroenterologia ed Endoscopia Digestiva, Dipartimento di Pediatria, Università di Messina, Messina, Italy 2 UOC di Gastroenterologia ed Endoscopia Digestiva, Istituto Giannina Gaslini di Genova, Genova, Italy 3 UOC di Gastroenterologia, Endoscopia ed Epatologia Pediatrica, Policlinico Universitario Umberto I, Sapienza Università di Roma, Roma, Italy 4 UOC di Chirurgia ed Endoscopia Digestiva, Ospedale Pediatrico Bambino Gesù, Roma, Italy 5 UOC di Gastroenterologia ed Endoscopia Digestiva, AOU di Parma, Parma, Italy 6 Unità di Gastroenterologia, Endoscopia Digestiva, Epatologia e Cura del Bambino con Trapianto di Fegato, Università degli Studi di Padova, Padova, Italy 7 Gastroenterologia ed Endoscopia Digestiva, Azienda Ospedaliera San Paolo, Polo Universitario, Università di Milano, Milano, Italy 8 Dipartimento di Scienze Mediche Traslazionali, Sezione di Pediatria, Università Federico II di Napoli, Napoli, Italy 9 Dipartimento di Scienze del Farmaco e dei Prodotti per la Salute, Università di Messina, Messina, Italy Objective: A retrospective population-based survey was conducted to assess the potential contribution of NSAIDs-related in upper gastrointestinal bleeding (UGIB) in pediatric population. Methods: A national retrospective study from seven pediatric Gastroenterology Units (GU) and one adult GU was conducted. Patients aged between 2 months and 16 years were recruited. UGIB was defined as esophageal and/or gastric and/or duodenal bleeding. The odds ratios for UGIB and NSAID was assessed by comparing exposure during the 7 days preceding the date of hospitalization. Results: A total of 51 children were included over 8 years. Hematemesis was present in most patients and melena was more frequent in group aged before 2 years. 88% of patients presented gastric lesions. The UGIB was associated with use of ibuprofen and paracetamol (adjusted OR 2.9, 95% CI 2.1 to 4.0). Paracetamol showed a lower risk compared to ibuprofen (OR 2.0 versus 3.7). Conclusions: This is the first Italian pediatric study to assess an extensive analysis about adverse effects NSAIDs. The UGIB is rare but may be avoided with use of correct doses in most patients. http://dx.doi.org/10.1016/j.dld.2014.07.033 e77 NARROW BAND IMAGING (NBI) COMBINED TO WATER IMMERSION TECHNIQUE (WIT): ANY DIAGNOSTIC YIELD FOR CELIAC DISEASE? A PEDIATRIC PROSPECTIVE STUDY Francesco Valitutti 1,∗ , Donatella Iorfida 1 , Salvatore Oliva 1 , Ilaria Celletti 1 , Stefania Leoni 1 , Silvia Gatti 1 , Chiara Maria Trovato 1 , Maria Barbato 1 , Monica Montuori 1 , Caterina Anania 1 , Antonio Tiberti 2 , Giovanni Di Nardo 1 , Salvatore Cucchiara 1 1 UOC di Gastroenterologia ed Epatologia Pediatrica, Sapienza-Università di Roma, Roma, Italy 2 Dipartimento di Medicina Interna e Specialità Mediche, Sapienza-Università di Roma, Roma, Italy Objective: The “multiple-biopsy” approach both in the duodenum and in the bulb is the best strategy to confirm the diagnosis of celiac disease (CD); however, this approach increases the invasiveness of the endoscopic procedure itself and is fairly timeconsuming. Our aim was to evaluate the diagnostic yield for CD of a single biopsy guided by narrow-band imaging combined with water immersion technique (NBI plus WIT) in pediatric patients. Methods: Prospective assessment of the diagnostic accuracy of the “NBI plus WIT”-driven biopsy approach versus the standard protocol in the suspicion of CD. Results: The experimental approach correctly diagnosed 35 out of 40 children with CD, with an overall diagnostic sensitivity of 87.5% (C.I. 95%: 77.3–97.7). An altered pattern at “NBI plus WIT” endoscopic visualization was significantly associated to villous atrophy at guided biopsy (Spearman Rho 0.637, p < 0.001). Concordance of “NBI plus WIT” endoscopic assessments was fairly high between two different operators (K: 0.884). After the passage through the pylorus of the endoscope, mean NBI plus WIT procedure time was 53.6 s, whereas mean time for multiple biopsy sampling was 218.2 s (p ≤ 0.0001). Conclusions: In presence of an altered “NBI plus WIT” pattern coupled to high anti-transglutaminase antibodies, a single guided biopsy might suffice to diagnose CD. When no altered mucosal pattern is visible even at “NBI plus WIT”, multiple bulbar and duodenal biopsies must be obtained to confirm CD diagnosis. http://dx.doi.org/10.1016/j.dld.2014.07.034 AZATHIOPRINE PHARMACOKINETICS IN EARLY ONSET INFLAMMATORY BOWEL DISEASE Gabriele Stocco 1 , Stefano Martelossi 2,∗ , Sara De Iudicibus 2 , Diego Favretto 2 , Eva Cuzzoni 1 , Raffaella Franca 2 , Giuliana Decorti 1 , Alessandro Ventura 2 1 Dipartimento di Scienze della Vita, Università di Trieste, Trieste, Italy 2 Clinica Pediatrica, Istituto Materno Infantile, Trieste, Italy Objective: To evaluate retrospectively azathioprine doses and metabolites concentration and their associations with patients’ age in children with IBD treated at Trieste Children’s Research Hospital Burlo Garofolo. Methods: Azathioprine doses, metabolites and clinical effects were assessed after at least 3 months of therapy in 10 early-onset (age < 6 years) and a control group of 71 non early-onset (age >12 and <18 years) pediatric IBD patients. Azathioprine dose was