Pediatric Gastroenterology, Hepatology & Nutrition

The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition (대한소아소화기영양학회)
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Characteristics of Upper Gastrointestinal Tract Involvement in Korean Pediatric Crohn's Disease: A Multicenter Study

  • Park, Ji Hyoung (Department of Pediatrics, Gachon University Gil Medical Center) ;
  • Nam, Hye Na (Department of Pediatrics, Gachon University Gil Medical Center) ;
  • Lee, Ji-Hyuk (Department of Pediatrics, Chungbuk National University Hospital) ;
  • Hong, Jeana (Department of Pediatrics, Kangwon National University School of Medicine) ;
  • Yi, Dae Yong (Department of Pediatrics, Chung-Ang University Hospital) ;
  • Ryoo, Eell (Department of Pediatrics, Gachon University Gil Medical Center) ;
  • Jeon, In Sang (Department of Pediatrics, Gachon University Gil Medical Center) ;
  • Tchah, Hann (Department of Pediatrics, Gachon University Gil Medical Center)
  • Received : 2017.08.26
  • Accepted : 2017.10.05
  • Published : 2017.12.30
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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 $14.1{\pm}2.1$ 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 ($60.7{\pm}27.1$ vs. $43.0{\pm}27.6mm/h$, p=0.037) and C-reactive protein ($16.5{\pm}28.2$ vs. $6.62{\pm}13.4mg/dL$, 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.

Keywords

References

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