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Published on: August 24, 2019

The clinical significance of focal active colitis in pediatric patients

Wei Xin1, Pamela I Brown, Joel K Greenson

  • 1Department of Pathology, University of Michigan Health System, Ann Arbor, Michigan 48109-0054, USA. facjkgmd@umich.edu

The American Journal of Surgical Pathology
|July 29, 2003
PubMed

Insights

Focal active colitis in children, unlike in adults, frequently indicates Crohn's disease. This finding highlights the importance of recognizing this condition in pediatric patients for timely diagnosis and management.

Area of Science:

  • Pediatric Gastroenterology
  • Colorectal Pathology
  • Inflammatory Bowel Disease

Background:

  • Focal active colitis (FAC) significance is established in adults, but poorly understood in children.
  • Adult studies show variable Crohn's disease (CD) incidence (0-13%) and high infectious colitis rates (~50%) in FAC.
  • Pediatric FAC data is limited, necessitating further investigation.

Purpose of the Study:

  • To investigate the clinical significance and outcomes of focal active colitis in pediatric patients.
  • To determine the incidence of Crohn's disease and other conditions in children diagnosed with FAC.
  • To compare pediatric FAC findings with existing adult literature.

Main Methods:

  • Retrospective review of 31 pediatric focal active colitis cases diagnosed between 1989-2000.
  • Analysis of pathological variables: crypt inflammation, lamina propria inflammation.
  • Clinical follow-up data extraction from patient charts for outcomes.

Main Results:

  • Eight of 29 (27.6%) pediatric patients developed Crohn's disease.
  • Nine (31%) had acute infectious-type colitis (one C. difficile).
  • Eight (27.6%) had idiopathic FAC; others had allergic colitis, ulcerative colitis, or Hirschsprung's disease.

Conclusions:

  • Pediatric focal active colitis has a significantly higher incidence of Crohn's disease compared to adults.
  • Prompt recognition and documentation of pediatric FAC are crucial for identifying children at high risk for CD.
  • Further research is needed to understand the long-term implications of idiopathic FAC in children.

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