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Clinical characteristics of idiopathic ulcerative colitis in children
Zoran Leković1, Nedeljko Radlović, Radivoj Brdar
1University Children's Hospital, Belgrade, Serbia. zlekovic2000@yahoo.com
Insights
Idiopathic ulcerative colitis (IUC) in children presents with chronic diarrhea and weight loss. Treatment involves aminosalicylates, with glucocorticoids and azathioprine for severe cases.
Area of Science:
- Pediatric Gastroenterology
- Inflammatory Bowel Disease Research
- Clinical Pediatrics
Background:
- Idiopathic ulcerative colitis (IUC) is a rare childhood inflammatory bowel disease, typically affecting children over 10 years old.
- Diagnosis in children is exceptionally rare below the age of 10.
- Understanding IUC in pediatric populations is crucial for timely diagnosis and management.
Purpose of the Study:
- To analyze the clinical manifestations, symptoms, and therapeutic strategies for pediatric IUC.
- To provide insights into the presentation and treatment of IUC in a young patient cohort.
- To establish evidence-based guidelines for managing IUC in children.
Main Methods:
- Retrospective analysis of 17 pediatric patients diagnosed with IUC.
- Diagnosis confirmed through characteristic endoscopic and pathohistological findings.
- Evaluation of clinical signs, symptoms, laboratory markers, and treatment outcomes.
Main Results:
- Chronic mucosal hemorrhagic diarrhea (16/17 patients) and weight deficiency (10/17) were primary symptoms.
- Other significant findings included recurrent abdominal pain, fever, slowed maturation, anorexia, and tenesmus.
- Laboratory abnormalities included elevated inflammatory markers, sideropenia, anemia, and hypoalbuminemia.
Conclusions:
- Key indicators of pediatric IUC include chronic mucous hemorrhagic diarrhea, weight loss, and sideropenic anemia.
- Aminosalicylates form the cornerstone of therapy.
- More severe cases necessitate initial glucocorticoid use, followed by azathioprine for steroid-dependent conditions.
Introduction:
Idiopathic ulcerative colitis (IUC) represents a rare disease of childhood. It usually occurs at age over 10 years, and below that exceptionally rarely.
Objective:
The aim of the paper was to analyze the clinical signs, symptoms and therapeutic procedures in children with IUC.
Methods:
The aims of the paper were based on a sample of 17 children (11 male and 6 female, mean age 11.90 +/- 3.50 years; range 3.8-17.5 years) with IUC. The disease diagnosis was based on characteristic endoscopic and pathohistological findings.
Results:
The basic signs of the disease involved chronic mucosal haemorrhagic diarrhoea which was confirmed in 16 of 17 patients, with body weight deficiency (10), recurrent abdominal pain (6), fever (5), slowed-down maturation (5), marked anorexia (4), and tenesmus (3).Two patients had recurrent aphthous stomatitis, 2 anal fissures, 2 arthralgia, one autoimmune hepatitis and one pyoderma gangrenosum. None of the children had longitudinal growth retardation. Elevated sedimentation rate and C-reactive protein in blood were registered in 11, sideropenia in 10, anaemia in 6 and hypoalbuminemia in 3 patients. The remission of proctosigmoiditis and left-sided colitis was achieved with aminosalicylates, and of pancolitis with the combination of aminosalicylates and glucocorticoids, except in cases of steroid-dependent colitis, which additionally required azathioprine.
Conclusion:
The main signs of IUC in children are chronic mucous haemorrhagic diarrhoea, body weight loss and sideropenic anaemia, while the basic therapy consists of aminosalicylates, and in more severe cases of the disease the initial use of glucocorticoids and later azathioprine.
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