Adeniyi Oluwafunmilayo F, Odeghe Emuobor, Olatona Foluke A, Lawal Mary, Onywekwelu Vincent I, Akinbolagbe Yeside O, Ikobah Joanah M
Pediatrics/Gastroenterology, College of Medicine, University of Lagos, Lagos, NGA.
Pediatrics/Gastroenterology, Lagos University Teaching Hospital, Lagos, NGA.
Cureus. 2020 Apr 27;12(4):e7848. doi: 10.7759/cureus.7848.
Inflammatory bowel disease (IBD), though well described in the Caucasian population, is rarely encountered in the black African children. The aim of this study was to increase the awareness of this emerging condition in African children and highlight the constraints of management in a resource-limited setting like Nigeria.
This study included an audit of children with IBD who were seen between January 2015 and February 2020 at the Lagos University Teaching Hospital (LUTH). The clinical records of children aged one to 16 years who presented with recurrent abdominal pain, weight loss, and gastrointestinal (GI) bleeding with clinical suspicion of IBD were reviewed. Clinical features, endoscopic findings, histopathologic findings, and treatment were documented.
Eight children with IBD were seen during the study period. The median age was 12.0 years (range: five to 15 years). The most common reported concerns in the children were chronic abdominal pain [seen in four patients (50%)] and bloody diarrhea [seen in three patients (42.30%)]. Weight loss and arthritis were seen in three (37.5%) and one (12.5%) children, respectively. Endoscopy confirmed two cases of Crohn's disease (CD), three cases of ulcerative colitis (UC), and three cases of indeterminate colitis (IC). The children with CD were treated with steroids and exclusive enteral nutrition, with one patient receiving methotrexate, while the UC and IC patients received 5-aminosalicylate therapy.
Although IBD is uncommon in Nigeria, a high index of suspicion is vital to enable early diagnosis and appropriate treatment. Management in the African setting is severely constrained by limited access to endoscopy facilities and nonavailability of other effective treatment options such as biologic agents.
炎症性肠病（IBD）在白种人群中已有详尽描述，但在非洲黑人儿童中却很少见。本研究的目的是提高对非洲儿童中这种新出现疾病的认识，并强调在尼日利亚这样资源有限的环境中管理方面的限制因素。
本研究包括对2015年1月至2020年2月在拉各斯大学教学医院（LUTH）就诊的IBD患儿进行的一项审核。对年龄在1至16岁、出现反复腹痛、体重减轻和胃肠道（GI）出血且临床怀疑为IBD的患儿的临床记录进行了回顾。记录了临床特征、内镜检查结果、组织病理学结果和治疗情况。
在研究期间共诊治了8例IBD患儿。中位年龄为12.0岁（范围：5至15岁）。患儿中最常见的主诉是慢性腹痛[4例（50%）]和血性腹泻[3例（42.30%）]。体重减轻和关节炎分别见于3例（37.5%）和1例（12.5%）患儿。内镜检查确诊2例克罗恩病（CD）、3例溃疡性结肠炎（UC）和3例不确定性结肠炎（IC）。CD患儿接受了类固醇和全肠内营养治疗，1例患儿接受了甲氨蝶呤治疗，而UC和IC患儿接受了5-氨基水杨酸治疗。
虽然IBD在尼日利亚并不常见，但高度的怀疑指数对于早期诊断和恰当治疗至关重要。在非洲环境下，管理受到内镜检查设施获取有限以及生物制剂等其他有效治疗选择无法获得的严重限制。
