Clinical characteristics and prognosis of children with perianal fistulizing Crohn's disease.
10.7499/j.issn.1008-8830.2308119
- Author:
You-Hong FANG
1
;
You-You LUO
1
;
Rui-Fang ZHANG
;
Qi CHENG
1
;
Jie CHEN
1
Author Information
1. Department of Gastroenterology, Children's Hospital, Zhejiang University School of Medicine/National Clinical Research Center for Child Health/National Children's Regional Medical Center, Hangzhou 310052, China (Chen J, Email: 6185020@zju.edu. cn).
- Publication Type:Journal Article
- Keywords:
Child;
Clinical characteristic;
Crohn's disease;
Perianal fistulizing Crohn's disease;
Treatment
- MeSH:
Child;
Male;
Humans;
Crohn Disease/complications*;
Retrospective Studies;
Prognosis;
Infliximab/therapeutic use*;
Rectal Fistula/therapy*
- From:
Chinese Journal of Contemporary Pediatrics
2024;26(1):42-47
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVES:To investigate the clinical characteristics, treatment, and prognosis of children with perianal fistulizing Crohn's disease (pfCD).
METHODS:A retrospective analysis was conducted on the children, aged 6-17 years, who were diagnosed with Crohn's disease (CD) from April 2015 to April 2023. According to the presence or absence of perianal fistulizing lesions, they were divided into two groups: pfCD (n=60) and non-pfCD (n=82). The two groups were compared in terms of clinical characteristics, treatment, and prognosis.
RESULTS:The incidence of pfCD was 42.3% (60/142). The proportion of males in the pfCD group was higher than that in the non-pfCD group. Compared with the non-pfCD group, the pfCD group had a significantly higher proportion of children with involvement of the colon and small intestine or those with upper gastrointestinal lesions (P<0.05). Compared with the non-pfCD group, the pfCD group had a significantly higher rate of use of infliximab during both induction and maintenance treatment (P<0.05). In the pfCD group, the children with complex anal fistula accounted for 62% (37/60), among whom the children receiving non-cutting suspended line drainage accounted for 62% (23/37), which was significantly higher than the proportion among the children with simple anal fistula patients (4%, 1/23) (P<0.05). There were no significant differences between the two groups in mucosal healing rate and clinical remission rate at week 54 of treatment (P>0.05). The pfCD group achieved a fistula healing rate of 57% (34/60) at week 54, and the children with simple anal fistula had a significantly higher rate than those with complex anal fistula (P<0.05).
CONCLUSIONS:There is a high incidence rate of pfCD in children with CD, and among the children with pfCD, there is a high proportion of children with the use of biological agents. There is a high proportion of children receiving non-cutting suspended line drainage among the children with complex anal fistula. The occurrence of pfCD should be closely monitored during the follow-up in children with CD.
