Comparison of clinical features between pediatric patients with inflammatory bowel disease and Clostridium difficile infection
10.3760/cma.j.cn101480-20221025-00170
- VernacularTitle:儿童炎症性肠病与艰难梭菌感染的临床特征比较
- Author:
Lina SUN
1
;
Ying FANG
1
;
Fengfan WANG
1
;
Xiaoxia REN
1
;
Hongbin YANG
1
;
Ya′nan HAN
1
Author Information
1. 西安交通大学附属儿童医院消化科，西安 710003
- Publication Type:Journal Article
- Keywords:
Inflammatory bowel disease;
Children;
Clostridium difficile;
Laboratory test;
Differential diagnosis
- From:
Chinese Journal of Inflammatory Bowel Diseases
2023;07(3):250-254
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the clinical features between inflammatory bowel disease (IBD) and Clostridium difficile infection (CDI) in children. Methods:A cross-sectional study was conducted. Clinical data of patients initially diagnosed IBD and CDI in the Affiliated Children′s Hospital of Xi′an Jiaotong University from August 2017 to August 2022 were collected retrospectively. The age, gender, symptom, laboratory test indexes of children in the two groups were analyzed and compared.Results:A total of 44 children [24 males, 20 females; median age, 9.04 (5.34, 12.50) years] were included in IBD group and there were 30 patients with Crohn′s disease (CD), 12 with ulcerative colitis (UC) and 2 with IBD unclassified (IBDU). A total of 45 children [28 males, 17 females; median age, 4.00 (2.38, 6.00) years] were included in CDI group. There was no significant difference in gender between the two groups (χ 2 = 0.54, P = 0.4625). The age of the CDI group was younger than that of the IBD group, and the difference was statistically significant ( U = 568.50, P = 0.0004). The incidences of diarrhea, hematochezia, abdominal pain and fever were high both in patients with IBD and CDI. The more common symptom in IBD group was abdominal pain, and its ratio was significantly higher than that of CDI group (61.36% vs. 40.00%, χ 2 = 4.06, P = 0.0439). The common clinical manifestations in CDI group were diarrhea and hematochezia, with a significantly higher proportion compared to the IBD group (diarrhea: 71.11% vs. 47.73%, χ 2 = 6.48, P = 0.0109; hematochezia: 75.56% vs. 50.00%, χ 2 = 6.23, P = 0.0126). The duration of symptoms in the IBD group was significantly longer than that in the CDI group ( U = 437.50, P<0.01). Compared with the CDI group, IBD patients had higher level of white blood cell count, neutrophil ratio, platelet count, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR), while lower level of hemoglobin and albumin, and all the differences were statistically significant (all P<0.05) . Conclusions:IBD and CDI have similar symptoms, however abdominal pain is more common in the patients with IBD, diarrhea and hematochezia are more common in patients with CDI. The duration of symptoms in IBD patients is longer, and the level of CRP and ESR is higher. These clinical features can be used to differentiate the patients with initially diagnosed IBD from CDI.
