Upper gastrointestinal involvement in paediatric onset Crohn's disease: Prevalence and clinical implications |
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| Affiliation: | 1. Department of Paediatrics, IRCCS Burlo Garofolo-University of Trieste, Italy;2. Gastrointestinal Pathophysiology and Endoscopy, University Department of Paediatrics, Children''s Hospital, Spedali Civili, Brescia, Italy;1. Universidade Federal de Pernambuco (UFPE), Recife, PE, Brazil;2. Hospital das Clínicas, Universidade Federal de Pernambuco (UFPE), Recife, PE, Brazil;3. Centro de Pesquisas em Alergia e Imunologia, Universidade Federal de Pernambuco (UFPE), Recife, PE, Brazil;4. Department of Internal Medicine, Universidade Federal de Pernambuco (UFPE), Recife, PE, Brazil;5. Department of Pediatrics, Universidade Federal de Pernambuco (UFPE), Recife, PE, Brazil;6. Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Brazil;1. Division of Pulmonary Medicine, Department of Pediatrics, Cincinnati Children''s Hospital Medical Center, Cincinnati, Ohio;5. Division of Gastroenterology, Hepatology, and Nutrition, Cincinnati Children''s Hospital Medical Center, Cincinnati, Ohio;2. Department of Physiology, University of Tennessee Health Science Center, Memphis, Tennessee;3. Department of Pediatrics, University of Tennessee Health Science Center, Memphis, Tennessee;4. Department of Pharmacology, University of Vermont, Burlington, Vermont;6. Department of Structural Biology and Developmental Neurobiology, St. Jude Children''s Research Hospital, Memphis, Tennessee;3. SickKids Hospital, University of Toronto, Toronto, Ontario, Canada;4. Division of Pediatric Gastroenterology and Nutrition, Cohen Children''s Medical Center of New York, New Hyde Park, New York;5. Mayo Clinic, Rochester, Minnesota;12. Children''s Memorial Health Institute, Warsaw, Poland;8. Goryeb Children''s Hospital/Atlantic Health, Morristown, New Jersey;9. Abbott GmbH & Co KG, Ludwigshafen, Germany;1. Department of Paediatrics, University of Naples ‘Federico II’, Naples, Italy;2. Division of Paediatric Gastroenterology Unit, University of Rome ‘La Sapienza’, Viale Regina Elena 342, 00161 Rome, Italy;3. Department of Experimental Medicine, University of Naples ‘Federico II’, Naples, Italy;4. Department of Pathology, University of Naples ‘Federico II’, Naples, Italy |
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| Abstract: | Background and aimsOur study evaluated the prevalence, the characteristics and implications of the upper gastrointestinal localisation (UGI+) in paediatric Crohn's Disease (CD) patients.MethodsThis prospective study evaluated 45 newly diagnosed CD patients at diagnosis and follow up with respect to CD localisation.ResultsAll patients presented CD at the colon and/or ileum. In 24/45 patients (53.3%, 12 F and 12 M) an UGI+ involvement was also found. UGI+ patients had a younger age of onset (10.9 years versus 12.6 years; P < 0.05). PCDAI at diagnosis was significantly higher in the UGI+ (41 vs. 25 P < 0.01). UGI+ patients were overall more symptomatic. Pancolitis and extraintestinal manifestations were also more frequent (19/24 (80%) vs. 12/21 (57%) P < 0.01). Growth was more impaired at diagnosis in UGI+ patients. By the end of the follow-up (mean 3 years, range 2 to 4) no significant difference was found in PCDAI (17 in UGI+ patients vs. 11 in UGI− P = NS), or the number of relapses. Weight and growth catch-up in UGI+ patients were comparable to UGI− ones. However, UGI+ patients required a more aggressive therapeutic approach.ConclusionAt least half of paediatric onset CD patients have an upper gastrointestinal localisation. UGI+ patients present an earlier onset and a more severe disease. The final outcome does not differ, but UGI+ patients require a more aggressive therapeutic approach. |
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