Upper gastrointestinal mucosal disease in pediatric Crohn disease and ulcerative colitis: a blinded, controlled study
| Autor: | Pramila Ramani, Jacinta Tobin, M. Murphy, Bidisa Sinha, Abdul Saleh |
|---|---|
| Rok vydání: | 2001 |
| Předmět: |
Male
medicine.medical_specialty Adolescent Duodenum Gastrointestinal Diseases Biopsy Gastroenterology Diagnosis Differential Duodenitis Crohn Disease Internal medicine Medicine Humans Colitis Child Granuloma medicine.diagnostic_test business.industry Esophageal disease Infant medicine.disease Inflammatory Bowel Diseases Ulcerative colitis digestive system diseases Endoscopy Case-Control Studies Child Preschool Pediatrics Perinatology and Child Health Colitis Ulcerative Female Gastritis medicine.symptom business Esophagitis |
| Zdroj: | Journal of pediatric gastroenterology and nutrition. 32(4) |
| ISSN: | 0277-2116 |
| Popis: | Upper gastrointestinal endoscopic biopsies often show histologic abnormalities in Crohn disease. Consequently, it has been proposed that routine endoscopy could help to distinguish Crohn disease from ulcerative colitis. Surprisingly, however, recent case reports and an uncontrolled study suggested that similar abnormalities may occur in ulcerative colitis. Therefore, a blinded, controlled study was performed.Esophageal, gastric antral, and duodenal biopsies from children with Crohn disease (n = 28) and ulcerative colitis (n = 14) were compared with those from controls undergoing endoscopy for suspected reflux esophagitis (n = 22). Two pathologists, unaware of patient identity and diagnosis, agreed on a consensus report. Severity of inflammation was scored semiquantitatively. Helicobacter pylori colonization was an exclusion criterion.Inflammation was reported as follows: esophagitis: controls 91%; Crohn disease: 72%; ulcerative colitis: 50%; gastritis: controls: 27%; Crohn disease: 92% (P0.001); ulcerative colitis: 69%; duodenitis: controls: 9%; Crohn disease: 33%; ulcerative colitis: 23%. In Crohn disease, granulomas were noted in 40% of patients (P = 0.001). Duodenal cryptitis was noted in 26% of patients with Crohn disease but not ulcerative colitis. In one patient with ulcerative colitis, neutrophilic infiltration of gastric glands was seen. Abnormalities seen in Crohn disease and ulcerative colitis included gastroduodenal ulceration (Crohn disease, 7%; ulcerative colitis, 8%), villus atrophy (Crohn disease, 11%; ulcerative colitis, 15%), and increased intraepithelial lymphocytes (Crohn disease, 15%; ulcerative colitis, 31% [P0.05]). None of these abnormalities was noted in the controls.Although the presence of granulomas can support a diagnosis of Crohn disease, severe inflammation and other abnormalities occur in the proximal gastrointestinal tract in Crohn disease and ulcerative colitis. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Plný text