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Pediatric Crohn disease presenting as appendicitis: differentiating features from typical appendicitis.
Julie A Bass1, Jennifer Goldman, Mary Anne Jackson
1Division of Gastroenterology, Children's Mercy Hospitals and Clinics, Kansas City, Missouri 64108, United States. jabass@cmh.edu
Crohn disease (CD) can mimic appendicitis. Preoperative low hemoglobin, low mean corpuscular volume (MCV), and high platelets in children suggest CD, enabling earlier diagnosis and better treatment.
Area of Science:
- Pediatric Gastroenterology
- Surgical Pathology
- Inflammatory Bowel Disease
Background:
- Crohn disease (CD) presentation can resemble acute appendicitis.
- Identifying preoperative indicators for CD risk is crucial.
Purpose of the Study:
- To identify preoperative clinical and laboratory differences between appendicitis patients who later developed Crohn disease (CD) and those who did not.
- To investigate the role of NOD2 mutations in CD patients presenting with appendicitis.
Main Methods:
- A 10-year retrospective case-control study compared appendicitis patients who developed CD with matched controls.
- Demographic, laboratory, and clinical data were analyzed.
- Appendectomy specimens were genotyped for NOD2 mutations.
Main Results:
- Eight of 2718 appendicitis patients developed CD.
- CD patients had lower hemoglobin and mean corpuscular volume (MCV), and higher platelets compared to controls (p < 0.0001).
- NOD2 mutation frequency in CD patients was 25%.
Conclusions:
- Low hemoglobin, low MCV, and high platelets in pediatric appendicitis patients warrant further evaluation for Crohn disease (CD).
- Early CD diagnosis improves treatment outcomes and quality of life.
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