Clinical Features and Course of Crohn Disease in Children

Lee, Na Young; Park, Jae Hong

Abstract

BACKGROUND/AIMS: The aim of this study was to evaluate the clinical features and course of Crohn disease (CD) in children.
METHODS
The medical records of 30 patients diagnosed with CD between January 1996 and December 2005 were reviewed retrospectively.
RESULTS
The actual number of newly diagnosed patients with CD has increased during the 8-year period. The male/female ratio was 2:1 and the mean age at diagnosis was 10.6+/-4.3 years. The major symptoms of CD at diagnosis were abdominal pain (79.2%), weight loss (54.2%), perianal lesion (54.2%), diarrhea (45.8%), hematochezia (41.7%), anemia (29.2%), and fever (23.3%). The disease location of CD was the small bowel in 33.3%, the large bowel in 12.5% and both the small and large bowel in 54.2%. Granuloma was found in 54.2% of patients. The relapse rate of CD in the group with a higher pediatric Crohn disease activity index (PCDAI) at diagnosis (> or =30) was higher than in the group with a lower PCDAI (<30). The cumulative relapse rates of the patients with granuloma were 30.2% within 1 year and 53.8% within 5 years after the diagnosis.
CONCLUSIONS
The incidence of CD in children appears to be increasing. Granuloma formation and a higher score of the PCDAI are associated with a more severe disease course. Pediatric CD may have a somewhat different clinical presentation from older-onset CD.