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Published on: September 22, 2019
Clinical Features and Extraintestinal Manifestations of Crohn Disease in Children
Young Ah Lee1, Peter Chun2, Eun Ha Hwang2
1Good Gang-An Hospital, Busan, Korea.
Insights
Perianal diseases, including fistulas and abscesses, are common in Korean pediatric Crohn disease (CD) patients at diagnosis. Early anal inspection is crucial for diagnosing CD in children, as these manifestations can be initial indicators.
Area of Science:
- Pediatric Gastroenterology
- Inflammatory Bowel Disease Research
- Clinical Epidemiology
Background:
- Crohn disease (CD) is a chronic inflammatory bowel disease with diverse clinical presentations.
- Understanding the specific characteristics of pediatric CD in different ethnic populations is essential for accurate diagnosis and management.
- Extraintestinal manifestations (EIMs) can significantly impact patient morbidity.
Purpose of the Study:
- To investigate the clinical features of Crohn disease (CD) in Korean pediatric patients.
- To identify the prevalence and types of extraintestinal manifestations (EIMs) associated with pediatric CD in this population.
Main Methods:
- Retrospective review of medical records for 73 Korean children diagnosed with CD.
- Analysis of demographic data, clinical characteristics, and CD phenotype using the Montreal classification.
- Detailed investigation of the clinical features and course of EIMs.
Main Results:
- The study included 73 pediatric patients (71.2% male) with a mean age of 12.5 years.
- Ileocolonic disease (76.7%) was the most common location, and the inflammatory phenotype (84.9%) predominated.
- Perianal diseases (abscesses/fistulas) were present in 50.7% of patients at diagnosis; common EIMs included anal skin tags (34.2%) and hypertransaminasemia (27.4%).
Conclusions:
- Perianal diseases are highly prevalent in Korean pediatric CD patients at diagnosis.
- Routine anal inspection is recommended for Korean children with suspected CD, as perianal manifestations can be early diagnostic clues.
- These findings highlight the importance of recognizing specific EIMs for timely CD diagnosis in pediatric populations.
Purpose:
The aim of this study was to investigate the clinical features and extraintestinal manifestations (EIMs) of Crohn disease (CD) in Korean pediatric patients.
Methods:
The medical records of 73 children diagnosed with CD were retrospectively reviewed. Data regarding baseline demographic and clinical characteristics, including CD phenotype at diagnosis based on the Montreal classification, and clinical features and course of EIMs were investigated.
Results:
Fifty-two (71.2%) of the patients were males. The mean age of the patients was 12.5 years. The mean follow-up period was 3.4 years. The disease location was ileal in 3 (4.1%) of the patients, colonic in 13 (17.8%), ileocolonic in 56 (76.7%). The clinical behavior was inflammatory in 62 (84.9%) of the patients, stricturing in 8 (11.0%), and penetrating in 3 (4.1%). Perianal abscesses or fistulas were found in 37 (50.7%) of the patients. EIMs observed during the study period were anal skin tag in 25 patients (34.2%), hypertransaminasemia in 20 (27.4%), peripheral arthritis in 2 (2.7%), erythema nodosum in 2 (2.7%), vulvitis in 1 (1.4%), uveitis in 1 (1.4%), and pulmonary thromboembolism in 1 (1.4%).
Conclusion:
Perianal diseases and manifestations were present in more than half of Korean pediatric CD patients at diagnosis. Inspection of the anus should be mandatory in Korean children with suspicious CD, as perianal fistulas, abscesses, and anal skin tags may be the first clue to the diagnosis of CD.
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