Abstract Objective To study the clinical features and treatment of pediatric Crohn's disease (CD). Methods Clinical data of 10 children with active CD diagnosed between 2005 and 2013 were retrospectively reviewed. Results Abdominal pain, diarrhea, and bloody stools were the most common symptoms in these patients, usually accompanied by different degrees of growth retardation and nutritional disorders. Fever was the main extraintestinal manifestation. Enteroscopy showed discontinuous and segmental mucosal hyperaemia and erosion, cobblestone appearance and mucosal ulceration. Abdominal ultrasound revealed uneven and segmental thickening of the intestinal wall. The pathological esamination showed many lymphocytes, eosinophils and plasma cells infiltrating into the lamina propria and partial atrophy of mucosal gland. C-reactive protein (CRP) level was significantly lower in the remission stage than in the acute stage and the recurrence stage (PPConclusions Pediatric CD has no specific clinical manifestations and laboratory test results. ESR and CRP can be used as the markers for evaluating the disease progression. 5-ASA has certain efficacy in inducing and maintaining remission of pediatric CD. There is a certain correlation between treatment outcome and the PCDAI score in the early stage of disease.
Hyams J, Markowitz J, Otley A, et al. Evaluation of the pediatric crohn disease activity index: a prospective multicenter experience[J]. J Pediatr Gastroenterol Nutr, 2005, 41(4): 416- 421.
[5]
Adamiak T, Walkiewicz-Jedrzejczak D, Fish D, et al. Incidence, clinical characteristics, and natural history of pediatric IBD in Wisconsin: a population-based epidemiological study[J]. Inflamm Bowel Dis, 2013, 19(6): 1218-1223.
[6]
Wang XQ, Zhang Y, Xu CD, et al. Inflammatory bowel disease in Chinese children: a multicenter analysis over a decade from Shanghai[J]. Inflamm Bowel Dis, 2013, 19(2): 423-428.
[7]
Chu HP, Logarajah V, Tan N, et al. Paediatric inflammatory bowel disease in a multiracial Asian country[J]. Singapore Med J, 2013, 54(4): 201-205.
[8]
Bousvaros A, Sylvester F, Kugathasan S. Challenges in pediatric inflammatory bowel disease[J]. Inflamm Bowel Dis, 2006, 12(9): 885-913.
[9]
De Greef E, Mahachie John JM, Hoffman I. Profile of pediatric Crohn's disease in Belgium[J]. J Crohns Colitis, 2013, 7(11): e588-e598.
[10]
Lambert B, Lemberg DA, Leach ST, et al. Longer-term outcomes of nutritional management of Crohn's disease in children[J]. Dig Dis Sci, 2012, 57(8): 2171-2177.
Leleiko NS, Lobato D, Hagin S. 6-Thioguanine levels in pediatric IBD patients: adherence is more important than dose[J]. Inflamm Bowel Dis, 2013, 19(12): 2652-2658.
[13]
Walters TD, Kim M, Denson LA. Comparative effectiveness of early therapy with anti-tumor necrosis factor-α vs an immunomodulator in children with Crohn's disease[J]. Gastroenterology, 2014, 146(2): 383-391.