Related Experiment Videos
[Follow-up of 60 children with ulcerative colitis and Crohn disease]
M Teufel1, H Meyer-Hohnloser, E M Mörcke
1Universitäts-Kinderklinik, Mannheim.
Insights
This study followed children with ulcerative colitis (UC) and Crohn's disease (CD), finding CD courses generally more severe with complications like intestinal stenosis and osteoporosis. UC relapses were linked to stress and winter, with arthritis and allergies as common late complications.
Area of Science:
- Pediatric Gastroenterology
- Inflammatory Bowel Disease (IBD) Research
- Clinical Pediatrics
Context:
- Investigated the long-term clinical courses of pediatric ulcerative colitis (UC) and Crohn's disease (CD).
- Focused on disease progression, complications, and psychosocial aspects in young patients.
- Compared the severity and outcomes between UC and CD in a pediatric cohort.
Purpose:
- To analyze and compare the clinical trajectories of pediatric UC and CD.
- To identify common complications and relapse triggers in pediatric IBD.
- To explore the psychosocial characteristics of children with CD.
Summary:
- Ulcerative colitis (UC) patients presented with mucohemorrhagic feces, with relapses often associated with emotional stress and winter. Common complications included arthritis, osteoporosis, allergies, and diabetes mellitus.
- Crohn's disease (CD) courses were generally more severe, with high rates of intestinal stenosis, bowel resection, fistulas, abscesses, and steroid-induced osteoporosis.
- Psychological assessments indicated CD patients were introverted, family-oriented, and sought social approval, while most UC patients showed normal psychosomatic development.
Impact:
- Highlights the distinct and often severe clinical challenges in pediatric IBD, particularly Crohn's disease.
- Provides insights into potential triggers for UC relapses, aiding in management strategies.
- Underscores the need for comprehensive care addressing both physical and psychosocial needs of children with IBD.
Abstract:
The clinical courses of 60 children suffering from ulcerative Colitis (UC, n = 21) and Crohn's disease (CD, n = 39) were investigated over a period of 8.7 and 5.1 years respectively. At the time of diagnosis all UC-patients showed mucohemorrhagic feces. Relapses often occurred after emotional stress and in 81% of all patients during the winter season. Typical late complications were arthritis (6/21), osteoporosis (6/21), allergic diseases (8/21) and diabetes mellitus (2/21). However, the psychosomatic development appeared normal in at least 17/21 of these patients. Generally the courses in children with CD were more serious. Despite intensive therapy 15/39 children developed an intestinal stenosis which was followed by bowel resection in 11 of them. Further complications were fistulas (6/39), abscess-formations (4/39) and osteoporosis (12/39) due to steroid therapy. Only 12/39 showed a significant catch-up growth. Interviews and psychological tests revealed that CD-patients were introverted with strong connections to their families. Equally they longed for approval and social contact with their contemporaries.