Clinical characteristics and prognosis of children with perianal fistulizing Crohn's disease
10.7499/j.issn.1008-8830.2308119
- VernacularTitle:儿童肛周瘘管型克罗恩病的临床特征及预后
- Author:
You-Hong FANG
1
;
You-You LUO
;
Rui-Fang ZHANG
;
Qi CHENG
;
Jie CHEN
Author Information
1. 浙江大学医学院附属儿童医院/国家儿童健康与疾病临床医学研究中心/国家儿童区域医疗中心 消化内科,浙江杭州 310052
- Keywords:
Crohn's disease;
Perianal fistulizing Crohn's disease;
Clinical characteristic;
Treatment;
Child
- From:
Chinese Journal of Contemporary Pediatrics
2024;26(1):42-47
- CountryChina
- Language:Chinese
-
Abstract:
Objective 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.
