Department of Hepato-Gastroenterology, University Hospital of Grenoble, University of Grenoble Alpes, Grenoble, France.
Department of Gastroenterology and Inserm U1256 NGERE, University Hospital of Nancy, University of Lorraine, 1 Allée du Morvan, 54511, Vandoeuvre-lès-Nancy, France.
Dig Dis Sci. 2021 Aug;66(8):2712-2716. doi: 10.1007/s10620-020-06553-3. Epub 2020 Aug 18.
In rare cases, the diagnosis of Crohn's disease (CD) can only be achieved using small bowel capsule endoscopy (SBCE). We investigate the characteristics of patients with CD only visible on SBCE and assess their disease course.
Data of all adult patients with confirmed CD diagnosis based on SBCE with normal endoscopic and cross-sectional imaging findings were retrospectively collected in three tertiary-level hospitals from January 2014 to March 2020.
Thirteen patients were included. Ten patients were females, and the mean age at diagnosis was 36 years. Ileum was mostly involved (85%), while duodenum and jejunum were affected in 23% and 38% of the cases, respectively. Nine patients had one segment involved, while four subjects had two or three segments affected. All patients had inflammatory behavior. First treatment consisted of steroids in all cases, and six patients were later treated with immunosuppressant or biologics. After a mean follow-up of 27.5 months, no change in disease behavior, hospitalization, or CD-related surgery was observed.
CD only visible at SBCE is a rare condition with a more favorable disease course compared to general CD with a lower rate of complicated behavior, hospitalization, and surgery, despite a similar use of immunosuppressant or biologics.
在极少数情况下，只能通过小肠胶囊内镜（SBCE）来诊断克罗恩病（CD）。我们研究了仅在 SBCE 上可见的 CD 患者的特征，并评估了他们的疾病过程。
回顾性收集了 2014 年 1 月至 2020 年 3 月期间，在三家三级医院基于 SBCE 确诊的所有成人 CD 患者的数据，这些患者的内镜和影像学检查均正常。
共纳入 13 名患者，其中 10 名为女性，诊断时的平均年龄为 36 岁。回肠最常受累（85%），而十二指肠和空肠受累的比例分别为 23%和 38%。9 名患者受累一个节段，4 名患者受累两个或三个节段。所有患者均表现为炎症性病变。所有患者的初始治疗均为类固醇，6 名患者随后接受了免疫抑制剂或生物制剂治疗。在平均 27.5 个月的随访后，未观察到疾病行为、住院或与 CD 相关的手术发生变化。
仅在 SBCE 上可见的 CD 是一种罕见的情况，与一般 CD 相比，其病变行为、住院和手术的发生率较低，尽管免疫抑制剂或生物制剂的使用相似。
