Characteristics of Upper Gastrointestinal Tract Involvement in Korean Pediatric Crohn's Disease: A Multicenter Study.
10.5223/pghn.2017.20.4.227
- Author:
Ji Hyoung PARK
1
;
Hye Na NAM
;
Ji Hyuk LEE
;
Jeana HONG
;
Dae Yong YI
;
Eell RYOO
;
In Sang JEON
;
Hann TCHAH
Author Information
1. Department of Pediatrics, Gachon University Gil Medical Center, Incheon, Korea. ryoo518@gilhospital.com
- Publication Type:Multicenter Study ; Original Article
- Keywords:
Crohn disease;
Upper gastrointestinal tract;
Granuloma;
Helicobacter pylori;
Pediatrics
- MeSH:
Biopsy;
Blood Sedimentation;
C-Reactive Protein;
Child;
Cohort Studies;
Crohn Disease*;
Diagnosis;
Duodenal Ulcer;
Endoscopy;
Endoscopy, Digestive System;
Gastrointestinal Tract;
Granuloma;
Helicobacter pylori;
Humans;
Inflammation;
Pediatrics;
Prevalence;
Retrospective Studies;
Stomach Ulcer;
Upper Gastrointestinal Tract*
- From:Pediatric Gastroenterology, Hepatology & Nutrition
2017;20(4):227-235
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: Crohn's disease (CD) can involve any site of the gastrointestinal tract (GIT). However, the characteristics of upper GIT involvement in CD are unclear, especially in the Eastern pediatric population. This study aimed to estimate the prevalence of upper GIT involvement and identify the clinical features of Korean children with CD. METHODS: This was a retrospective multicenter cohort study that included 52 pediatric patients with CD who underwent esophagogastroduodenoscopy and biopsy. The clinical symptoms and endoscopic and histologic features of the upper GIT were identified according to the presence or absence of upper gastrointestinal symptoms. RESULTS: Among the 52 patients, upper GIT involvement was noted in 50.0% (26/52). The mean age at CD diagnosis was 14.1±2.1 years. Gastric ulcer was the most common lesion (19.2%) found on upper GIT endoscopy, followed by duodenal ulcers (15.4%). Chronic inflammation was the most common histopathologic feature (75.0%), followed by gastric erosion (17.3%). Granuloma was found in 9.6% of patients. Helicobacter pylori infection was identified in 5.8% of patients. Endoscopic and histologic findings were not significantly different, but the mean values of erythrocyte sedimentation rate (60.7±27.1 vs. 43.0±27.6 mm/h, p=0.037) and C-reactive protein (16.5±28.2 vs. 6.62±13.4 mg/dL, p=0.014) were significantly different between patients with and without upper gastrointestinal CD symptoms. CONCLUSION: Upper GIT involvement was relatively common in pediatric patients with CD irrespective of upper gastrointestinal symptoms, and H. pylori infection was relatively uncommon. The results of this study should aid the establishment of regional guidelines for upper GIT examination.
