Data supporting a response to treatment with exclusive enteral nutrition in pediatric colonic Crohn’s disease are few. We examined clinical and biochemical responses of ileal, colonic, and ileocolonic Crohn’s diseas...Data supporting a response to treatment with exclusive enteral nutrition in pediatric colonic Crohn’s disease are few. We examined clinical and biochemical responses of ileal, colonic, and ileocolonic Crohn’s disease and assessed the endoscopic and histological colonic mucosal response in the colonic and ileocolonic groups. We prospectively enrolled 65 children (age: 8- 17 years) with acute intestinal Crohn’s disease (Pediatric Crohn‘s Disease Activity Index PCDAI > 20). After ileocolonoscopy, gastroscopy, and a barium meal and follow- through, they were distributed into three groups (ileal, n = 12, ileocolonic, n = 39; and colonic, n = 14). All patients received exclusive polymeric feed as treatment, with a repeat endoscopy at completion of treatment. At enrollment the ileal group had significantly less severe disease (P = 0.05) compared to the colonic and ileocolonic groups. However, the colonic disease group showed the least fall in PCDAI scores at completion of treatment with enteral nutrition (P = 0.03), with the lowest remission rate (50% , vs 82.1% in the ileocolonic and 91.7% in the ileal group χ 2 test, P = 0.021). Endoscopic and histologic colonic mucosal assessment showed a posttreatment improvement in the ileocolonic (P ≤ 0.01) but not in the colonic disease group (P = ns). Children with disease in the colon respond better to enteral nutrition if the ileum is also involved. This may be due to different underlying inflammatory mechanisms. Detailed pretreatment assessment in studies of Crohn’ s disease according to disease distribution with appropriate individualized tailoring of treatment may be important in this regard.展开更多
Linear IgA disease has been reported inassociation with inflammatory bowel disease, in particular ulcerative colitis. We experienced a case of linear IgA disease that occurred simultaneously with colonic Crohn’ s dis...Linear IgA disease has been reported inassociation with inflammatory bowel disease, in particular ulcerative colitis. We experienced a case of linear IgA disease that occurred simultaneously with colonic Crohn’ s disease in a 55- year- old woman and rather unusually both skin and bowel disease improved in tandem. We report the presentation, investigations and subsequent improvement of our patient and speculate on possible causes.展开更多
目的探究CT小肠造影(CTE)对结肠型克罗恩病与溃疡性结肠炎的诊断及鉴别诊断价值。方法选取蚌埠医学院第一附属医院和南京中医药大学附属江苏省中医院于2019年1月~2022年1月收治的结肠型克罗恩病患者36例和溃疡性结肠炎患者36例行CTE检查...目的探究CT小肠造影(CTE)对结肠型克罗恩病与溃疡性结肠炎的诊断及鉴别诊断价值。方法选取蚌埠医学院第一附属医院和南京中医药大学附属江苏省中医院于2019年1月~2022年1月收治的结肠型克罗恩病患者36例和溃疡性结肠炎患者36例行CTE检查,分别观察两组影像特征,结合实验室指标、临床表现对克罗恩病和溃疡性结肠炎患者进行回顾性分析。结果36例克罗恩病患者中,CTE影像示肠壁不均匀增厚21例、肠道狭窄22例、瘘管形成7例及累及升结肠21例,均高于溃疡性结肠炎患者,差异有统计学意义(P<0.05);36例溃疡性结肠炎患者,粘液便18例及血便22例高于克罗恩病患者(P<0.05),溃疡性结肠炎患者平均发病年龄较结肠型克罗恩病患者平均发病年龄大(P<0.05)。克罗恩病患者与溃疡性结肠炎患者的C反应蛋白及红细胞沉降率含量均值分别为28.17 mg/L vs 17.67 mg/L、32.25 mm/h vs 22.95 mm/h;C反应蛋白及红细胞沉降率含量的平均值对克罗恩病与溃疡性结肠炎的鉴别无统计学意义(P>0.05)。结论通过CTE影像特征更直观地对结肠型克罗恩病与溃疡性结肠炎进行鉴别,结合临床、内镜表现及病理诊断,为治疗方案设计提供更可靠的依据。展开更多
文摘Data supporting a response to treatment with exclusive enteral nutrition in pediatric colonic Crohn’s disease are few. We examined clinical and biochemical responses of ileal, colonic, and ileocolonic Crohn’s disease and assessed the endoscopic and histological colonic mucosal response in the colonic and ileocolonic groups. We prospectively enrolled 65 children (age: 8- 17 years) with acute intestinal Crohn’s disease (Pediatric Crohn‘s Disease Activity Index PCDAI > 20). After ileocolonoscopy, gastroscopy, and a barium meal and follow- through, they were distributed into three groups (ileal, n = 12, ileocolonic, n = 39; and colonic, n = 14). All patients received exclusive polymeric feed as treatment, with a repeat endoscopy at completion of treatment. At enrollment the ileal group had significantly less severe disease (P = 0.05) compared to the colonic and ileocolonic groups. However, the colonic disease group showed the least fall in PCDAI scores at completion of treatment with enteral nutrition (P = 0.03), with the lowest remission rate (50% , vs 82.1% in the ileocolonic and 91.7% in the ileal group χ 2 test, P = 0.021). Endoscopic and histologic colonic mucosal assessment showed a posttreatment improvement in the ileocolonic (P ≤ 0.01) but not in the colonic disease group (P = ns). Children with disease in the colon respond better to enteral nutrition if the ileum is also involved. This may be due to different underlying inflammatory mechanisms. Detailed pretreatment assessment in studies of Crohn’ s disease according to disease distribution with appropriate individualized tailoring of treatment may be important in this regard.
文摘Linear IgA disease has been reported inassociation with inflammatory bowel disease, in particular ulcerative colitis. We experienced a case of linear IgA disease that occurred simultaneously with colonic Crohn’ s disease in a 55- year- old woman and rather unusually both skin and bowel disease improved in tandem. We report the presentation, investigations and subsequent improvement of our patient and speculate on possible causes.
文摘目的探究CT小肠造影(CTE)对结肠型克罗恩病与溃疡性结肠炎的诊断及鉴别诊断价值。方法选取蚌埠医学院第一附属医院和南京中医药大学附属江苏省中医院于2019年1月~2022年1月收治的结肠型克罗恩病患者36例和溃疡性结肠炎患者36例行CTE检查,分别观察两组影像特征,结合实验室指标、临床表现对克罗恩病和溃疡性结肠炎患者进行回顾性分析。结果36例克罗恩病患者中,CTE影像示肠壁不均匀增厚21例、肠道狭窄22例、瘘管形成7例及累及升结肠21例,均高于溃疡性结肠炎患者,差异有统计学意义(P<0.05);36例溃疡性结肠炎患者,粘液便18例及血便22例高于克罗恩病患者(P<0.05),溃疡性结肠炎患者平均发病年龄较结肠型克罗恩病患者平均发病年龄大(P<0.05)。克罗恩病患者与溃疡性结肠炎患者的C反应蛋白及红细胞沉降率含量均值分别为28.17 mg/L vs 17.67 mg/L、32.25 mm/h vs 22.95 mm/h;C反应蛋白及红细胞沉降率含量的平均值对克罗恩病与溃疡性结肠炎的鉴别无统计学意义(P>0.05)。结论通过CTE影像特征更直观地对结肠型克罗恩病与溃疡性结肠炎进行鉴别,结合临床、内镜表现及病理诊断,为治疗方案设计提供更可靠的依据。
