Significance of Perianal Lesion in Pediatric Crohn Disease
2
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Purpose: Despite the increasing incidence of pediatric Crohn disease (CD) in Korea, data on the characteristics of perianal lesions are scarce. Therefore, we aimed to investigate the characteristics of pediatric CD with accompany-ing perianal lesions in Korea.Methods: We retrospectively reviewed the medical records of children (age ≤18 years) with confirmed CD at Gachon University Gil Medical Center between 2000 and 2014. Patients were classified into two groups based on the presence or absence of any perianal lesions including skin tags. Additional analysis was performed according to the presence or absence of perianal perforating lesions.Results: Among the 69 CD children (mean age, 15.4 years) include in the analysis, 54 (78.3%) had a perianal lesion and 29 (42.0%) had a perianal perforating lesion. The median duration of chief complaints was longer in pediatric CD with any accompanying perianal lesions (5.40 months vs. 1.89 months, p=0.02), while there was no difference between pediatric CD with and without perianal perforating lesions (5.48 months vs. 4.02 months, p=0.18). Perianal symptoms preceded gastrointestinal symptoms in 13 of 29 (44.8%) patients with perianal perforating lesions.Conclusions: CD should be suspected in children with perianal lesions, even in circumstances when gastrointestinal symptoms are absent.
Abstract
Purpose: Despite the increasing incidence of pediatric Crohn disease (CD) in Korea, data on the characteristics of perianal lesions are scarce. Therefore, we aimed to investigate the characteristics of pediatric CD with accompany-ing perianal lesions in Korea.Methods: We retrospectively reviewed the medical records of children (age ≤18 years) with confirmed CD at Gachon University Gil Medical Center between 2000 and 2014. Patients were classified into two groups based on the presence or absence of any perianal lesions including skin tags. Additional analysis was performed according to the presence or absence of perianal perforating lesions.Results: Among the 69 CD children (mean age, 15.4 years) include in the analysis, 54 (78.3%) had a perianal lesion and 29 (42.0%) had a perianal perforating lesion. The median duration of chief complaints was longer in pediatric CD with any accompanying perianal lesions (5.40 months vs. 1.89 months, p=0.02), while there was no difference between pediatric CD with and without perianal perforating lesions (5.48 months vs. 4.02 months, p=0.18). Perianal symptoms preceded gastrointestinal symptoms in 13 of 29 (44.8%) patients with perianal perforating lesions.Conclusions: CD should be suspected in children with perianal lesions, even in circumstances when gastrointestinal symptoms are absent.
참고문헌 (22)
- Fakhoury M, "Inflammatory bowel disease: clinical aspects and treatments", J Inflamm Res, 7, pp.113~120 (2014)
- Bouguen G, "Nonfistulizing perianal Crohn's disease: clinical features, epidemiology, and treatment", Inflamm Bowel Dis, 16, pp.1431~1442 (2010)[DOI]
- Ingle SB, "The natural history of perianal Crohn's disease", Dig Liver Dis, 39, pp.963~969 (2007)[DOI]
- Peyrin-Biroulet L, "Perianal Crohn's disease findings other than fistulas in a population-based cohort", Inflamm Bowel Dis, 18, pp.43~48 (2012)[DOI]
- Nielsen OH, "Diagnosis and management of fistulizing Crohn's disease", Nat Clin Pract Gastroenterol Hepatol, 6, pp.92~106 (2009)[DOI]
- Keighley MR, "Current status and influence of operation on perianal Crohn's disease", Int J Colorectal Dis, 1, pp.104~107 (1986)[DOI]
- Keljo DJ, "Course and treatment of perianal disease in children newly diagnosed with Crohn's disease", Inflamm Bowel Dis, 15, pp.383~387 (2009)[DOI]
- Hellers G, "Occurrence and outcome after primary treatment of anal fistulae in Crohn's disease", Gut, 21, pp.525~527 (1980)[DOI]
- Van Assche G, "The second European evidence-based Consensus on the diagnosis and management of Crohn's disease: special situations", J Crohns Colitis, 4, pp.63~101 (2010)[DOI]
- Schwartz DA, "The natural history of fistulizing Crohn's disease in Olmsted County, Minnesota", Gastroenterology, 122, pp.875~880 (2002)[DOI]
- Siproudhis L, "Anal lesions: any significant prognosis in Crohn's disease?", Eur J Gastroenterol Hepatol, 9, pp.239~243 (1997)[DOI]
- Kim BJ, "Characteristics and trends in the incidence of inflammatory bowel disease in Korean children: a single-center experience", Dig Dis Sci, 55, pp.1989~1995 (2010)[DOI]
- Kelsen J, "Inflammatory bowel disease: the difference between children and adults", Inflamm Bowel Dis, 14(Suppl 2), pp.S9~S11 (2008)
- Sawczenko A, "Presenting features of inflammatory bowel disease in Great Britain and Ireland", Arch Dis Child, 88, pp.995~1000 (2003)[DOI]
- Kugathasan S, "Epidemiologic and clinical characteristics of children with newly diagnosed inflammatory bowel disease in Wisconsin: a statewide population-based study", J Pediatr, 143, pp.525~531 (2003)[DOI]
- Bufler P, "Recurrent abdominal pain in childhood", Dtsch Arztebl Int, 108, pp.295~304 (2011)
- Ye BD, "Clinical features and long-term prognosis of Crohn's disease in Korea", Scand J Gastroenterol, 45, pp.1178~1185 (2010)[DOI]
- Ye BD, "The clinical features and prognosis of Crohn's disease: a Korean multicenter nationwide cohort study", J Dly Sci, 8, pp.S315~ (2014)
- Yang SK, "Epidemiology of inflammatory bowel disease in the Songpa-Kangdong district, Seoul, Korea, 1986-2005: a KASID study", Inflamm Bowel Dis, 14, pp.542~549 (2008)[DOI]
- Park SH, "Long-term prognosis of Crohn's disease and its temporal change between 1981 and 2012: a hospital-based cohort study from Korea", Inflamm Bowel Dis, 20, pp.488~494 (2014)[DOI]
- Korelitz BI, "Anal skin tags: an overlooked indicator of Crohn's disease", J Clin Gastroenterol, 44, pp.151~152 (2010)[DOI]
- Young Ah Lee, "Clinical Features and Extraintestinal Manifestations of Crohn Disease in Children", Pediatric Gastroenterology, Hepatology & Nutrition, 19(4), pp.236~242 (2016), 대한소아소화기영양학회