Sharif F, McDermott M, Dillon M, Drumm B, Rowland M, Imrie C, Kelleher S, Harty S, Bourke B
Children's Research Centre and Department of Pathology, Our Lady's Hospital for Sick Children, Dublin, Ireland.
Am J Gastroenterol. 2002 Jun;97(6):1415-20. doi: 10.1111/j.1572-0241.2002.05785.x.
Focally enhanced gastritis (FEG) has been suggested as a specific diagnostic marker for patients with Crohn's disease. However, the utility of FEG for distinguishing Crohn's disease from ulcerative colitis is uncertain in adults, and the occurrence of this lesion in children has not been defined. The aim of this study was to evaluate the occurrence of FEG and other gastric histological abnormalities in children with inflammatory bowel disease (IBD) and to examine the utility of FEG in discriminating between ulcerative colitis and Crohn's disease.
This is a retrospective, case-controlled study of upper GI histopathological findings in children with IBD. Gastric histopathology was defined and graded according to the Updated Sydney System.
FEG was present in 28 of 43 (65.1%) children with Crohn's disease and five of 24 (20.8%) children with ulcerative colitis, compared to three of 132 (2.3%) children without IBD or one of 39 (2.6%) children with Helicobacter pylori infection. There were no differences between those with and without FEG with regard to upper GI symptoms or previous anti-inflammatory drug ingestion (5-aminosalicylic acid compounds or steroids). All patients with H. pylori infection had chronic antral gastritis, but only one child with H. pylori had FEG. In addition, mild to moderate chronic gastritis was present in 15 of 43 (34.9%) children with Crohn's disease and in 12 of 24 (50%) patients with ulcerative colitis.
The presence of FEG suggests underlying IBD. Although FEG is particularly common in children with Crohn's disease, it does not reliably differentiate between Crohn's disease and ulcerative colitis.
局灶性强化性胃炎（FEG）被认为是克罗恩病患者的一种特异性诊断标志物。然而，FEG在区分成人克罗恩病和溃疡性结肠炎方面的效用尚不确定，且该病变在儿童中的发生率尚未明确。本研究的目的是评估炎症性肠病（IBD）患儿中FEG及其他胃组织学异常的发生率，并检验FEG在区分溃疡性结肠炎和克罗恩病中的效用。
这是一项关于IBD患儿上消化道组织病理学结果的回顾性病例对照研究。胃组织病理学根据更新后的悉尼系统进行定义和分级。
43例克罗恩病患儿中有28例（65.1%）存在FEG，24例溃疡性结肠炎患儿中有5例（20.8%）存在FEG，相比之下，132例无IBD的患儿中有3例（2.3%）存在FEG，39例幽门螺杆菌感染患儿中有1例（2.6%）存在FEG。有无FEG的患儿在上消化道症状或既往抗炎药物摄入（5-氨基水杨酸类化合物或类固醇）方面无差异。所有幽门螺杆菌感染患儿均有慢性胃窦炎，但只有1例幽门螺杆菌感染患儿有FEG。此外，43例克罗恩病患儿中有15例（34.9%）存在轻度至中度慢性胃炎，24例溃疡性结肠炎患儿中有12例（50%）存在轻度至中度慢性胃炎。
FEG的存在提示潜在的IBD。虽然FEG在克罗恩病患儿中尤为常见，但它不能可靠地区分克罗恩病和溃疡性结肠炎。
