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Periappendiceal inflammation in pediatric ulcerative colitis
Caterina Strisciuglio1, Eleonora Giannetti, Francesca Paola Giugliano
1Department of Pediatrics, University of Naples "Federico II", Italy.
Inflammatory Bowel Diseases
|April 5, 2013
Summary
Periappendiceal inflammation (PAI) is a common skip lesion in pediatric ulcerative colitis (UC). It is more prevalent in newly diagnosed patients and linked to more extensive disease and higher inflammation in the ascending colon.
Area of Science:
- Pediatric Gastroenterology
- Inflammatory Bowel Disease Research
- Endoscopic and Histologic Diagnostics
Background:
- Ulcerative colitis (UC) can present with skip lesions.
- The appendiceal orifice has been identified as a skip lesion in adult UC.
- The prevalence of periappendiceal inflammation (PAI) in pediatric UC requires further investigation.
Purpose of the Study:
- To prospectively evaluate the prevalence of PAI in children with UC using endoscopy and histology.
- To determine the association between PAI and disease characteristics in pediatric UC.
Main Methods:
- Prospective study enrolling 50 children with UC diagnosed not beyond the hepatic flexure.
- Total colonoscopy with endoscopic and histologic evaluation for PAI.
- Comparison of disease extent, inflammation grade, and clinical activity between patients with and without PAI.
Main Results:
- PAI was endoscopically detected in 32% (16/50) of pediatric UC patients.
- PAI was more frequent in newly diagnosed patients (P=0.016) and associated with a greater disease extent (P=0.013).
- Patients with PAI showed a significantly higher histologic grade of inflammation in the ascending colon (P=0.014) and higher immunosuppressant use.
Conclusions:
- PAI is a frequent skip lesion in pediatric UC.
- PAI in children with UC is associated with new diagnoses, greater disease extent, and increased histologic inflammation.
- These findings highlight the importance of evaluating the appendiceal region in pediatric UC.
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