Pediatr Gastroenterol Hepatol Nutr.  2017 Dec;20(4):227-235. 10.5223/pghn.2017.20.4.227.

Characteristics of Upper Gastrointestinal Tract Involvement in Korean Pediatric Crohn's Disease: A Multicenter Study

• Park JH
• Nam HN
• Lee JH
• Hong J
• Yi DY
• Ryoo E
• Jeon IS
• Tchah H

• KMID: 2398904
• DOI: http://doi.org/10.5223/pghn.2017.20.4.227

Abstract

PURPOSE
Crohn's disease (CD) can involve any site of the gastrointestinal tract (GIT). However, the characteristics of upper GIT involvement in CD are unclear, especially in the Eastern pediatric population. This study aimed to estimate the prevalence of upper GIT involvement and identify the clinical features of Korean children with CD.
METHODS
This was a retrospective multicenter cohort study that included 52 pediatric patients with CD who underwent esophagogastroduodenoscopy and biopsy. The clinical symptoms and endoscopic and histologic features of the upper GIT were identified according to the presence or absence of upper gastrointestinal symptoms.
RESULTS
Among the 52 patients, upper GIT involvement was noted in 50.0% (26/52). The mean age at CD diagnosis was 14.1±2.1 years. Gastric ulcer was the most common lesion (19.2%) found on upper GIT endoscopy, followed by duodenal ulcers (15.4%). Chronic inflammation was the most common histopathologic feature (75.0%), followed by gastric erosion (17.3%). Granuloma was found in 9.6% of patients. Helicobacter pylori infection was identified in 5.8% of patients. Endoscopic and histologic findings were not significantly different, but the mean values of erythrocyte sedimentation rate (60.7±27.1 vs. 43.0±27.6 mm/h, p=0.037) and C-reactive protein (16.5±28.2 vs. 6.62±13.4 mg/dL, p=0.014) were significantly different between patients with and without upper gastrointestinal CD symptoms.
CONCLUSION
Upper GIT involvement was relatively common in pediatric patients with CD irrespective of upper gastrointestinal symptoms, and H. pylori infection was relatively uncommon. The results of this study should aid the establishment of regional guidelines for upper GIT examination.

Keyword

Crohn disease; Upper gastrointestinal tract; Granuloma; Helicobacter pylori; Pediatrics

MeSH Terms

Biopsy
Blood Sedimentation
C-Reactive Protein
Child
Cohort Studies
Crohn Disease*
Diagnosis
Duodenal Ulcer
Endoscopy
Endoscopy, Digestive System
Gastrointestinal Tract
Granuloma
Helicobacter pylori
Humans
Inflammation
Pediatrics
Prevalence
Retrospective Studies
Stomach Ulcer
Upper Gastrointestinal Tract*
C-Reactive Protein

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