Diagnostic yield of upper endoscopy in paediatric patients with Crohn's disease and ulcerative colitis. Subanalysis of the HUPIR registry |
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| Affiliation: | 1. Petz Aladár County Teaching Hosp., Győr, Hungary;2. 1st Dept. of Paediatrics, Semmelweis University, Budapest, Hungary;3. 1st Dept. of Medicine, Semmelweis University, Budapest, Hungary;4. Heim-Madarász Hosp., Budapest, Hungary;5. Dept. of Paediatrics, Szeged, Hungary;6. BAZ County Hosp., Miskolc, Hungary;7. Dept. of Paediatrics, Medical and Health Science Center, University of Debrecen, Hungary;8. Jósa Hosp., Nyíregyháza, Hungary;9. St. György Hosp., Székesfehérvár, Hungary;10. Dept. of Paediatrics, Pécs, Hungary;11. Csolnoky Hosp., Veszprém, Hungary;12. 2nd Dept. of Paediatrics, Semmelweis University, Budapest, Hungary;13. Markusovszky Hosp., Szombathely, Hungary;14. Pándy Hosp., Gyula, Hungary;15. Zala County Hosp., Zalaegerszeg, Hungary;p. Budai Children''s Hosp., Budapest, Hungary;q. Dept. of Medicine, University of Debrecen, Hungary;1. Digestive Endoscopy Unit, Catholic University, Rome, Italy;2. Digestive Endoscopy and Surgery Unit, Bambino Gesù Children Hospital, IRCCS, Rome, Italy;1. Department of Psychiatry, University of Connecticut, School of Medicine, Farmington, CT 06030, USA;2. The Center for Internet and Technology Addiction, 8 Lowell Road, West Hartford, CT 06119, USA;1. Colorectal Unit, Department of Surgery, Skåne University Hospital Malmö, Lund University, Malmö, Sweden;2. Department of Surgery, David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, CA, USA;1. ARUP Laboratories/University of Utah, Salt Lake City, UT 84108, USA;2. INSTAND, Society for Promoting Quality Assurance in Medical Laboratories, Ubierstr. 20, 40223 Duesseldorf, Germany;3. Klinikum der Universität München, Campus Innenstadt, Ludwig-Maximilians-Universität München, Ziemssenstr. 1, 80336 Munich, Germany;4. Department of Operative/Restorative Dentistry, Periodontology and Pedodontics, Ludwig-Maximilians-Universität München, Goethestr. 70, 80336 Munich, Germany;5. Laboratory Becker & Colleagues, Führichstr. 70, 81671 Munich, Germany;1. Department of Dentistry, Far Eastern Memorial Hospital, New Taipei City, Taiwan;2. Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan;3. Graduate Institute of Oral Biology, School of Dentistry, National Taiwan University, Taipei, Taiwan;4. Department of Dentistry, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan |
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| Abstract: | Background, aimsAccording to Porto Criteria upper gastrointestinal (UGI) endoscopy is recommended in patients with suspected inflammatory bowel disease (IBD). Nevertheless, previous studies revealed frequent involvement of UGI tract even in patients with ulcerative colitis (UC). The aim of the present study was to determine the diagnostic role of esophagogastroduodenoscopy (EGD) and assess the prevalence and different aspects of UGI involvement in children registered in the Hungarian Pediatric IBD Registry (HUPIR) from 1st of January 2007 to 31th of December 2009.MethodsTwenty seven institutes provided prospective follow-up data about newly diagnosed IBD patients to HUPIR. The registry was based on detailed questionnaire (76 parameters) involving anamnestic data, laboratory findings, activity indexes, diagnostic procedures, endoscopic examinations (EGD and ileocolonoscopy), and histological data. Localization and phenotype of disease were based on the Montreal classification criteria.ResultsDuring the 3-year period 420 children were diagnosed with IBD, 265 (63%) of them had Crohn's disease (CD), 130 (31%) UC, and 25 (6%) IBD-unclassified (IBD-U). The mean age at diagnosis was 13.2 years (range: 1.2–18 years). EGD was performed in 237 patients (56%), in most cases in patients suffering from CD. Macroscopic lesions on EGD were noted in 64% of patients with CD and 40% of children with UC. Characteristic lesions for CD (ulcer, erosion, aphthous lesion, and granuloma) were noted in 31% of CD patients, however, EGD helped to establish the final diagnosis in 9% of CD patients (diagnostic yield, 9%).ConclusionsThere was a high frequency of UGI involvement in children with CD and UC. One third of CD patients showed significant lesions at upper endoscopy and one patient out of ten had real diagnostic help from EGD. |
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