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

Authors
Park, Ji HyoungNam, Hye NaLee, Ji-HyukHong, JeanaYi, Dae YongRyoo, EellJeon, In SangTchah, Hann
Issue Date
Dec-2017
Publisher
KOREAN SOC PEDIATRIC GASTROENTEROLOGY & NUTRITION
Keywords
Crohn disease; Upper gastrointestinal tract; Granuloma; Helicobacter pylori; Pediatrics
Citation
PEDIATRIC GASTROENTEROLOGY HEPATOLOGY & NUTRITION, v.20, no.4, pp.227 - 235
Journal Title
PEDIATRIC GASTROENTEROLOGY HEPATOLOGY & NUTRITION
Volume
20
Number
4
Start Page
227
End Page
235
URI
https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/5384
DOI
10.5223/pghn.2017.20.4.227
ISSN
2234-8646
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.
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