Poddar Ujjal, Yachha Surender Kumar, Srivastava Anshu, Kumari Niraj
Department of Pediatric Gastroenterology Sanjay Gandhi Postgraduate Institute of Medical Sciences Lucknow India.
Department of Pathology Sanjay Gandhi Postgraduate Institute of Medical Sciences Lucknow India.
JGH Open. 2020 Apr 26;4(5):860-866. doi: 10.1002/jgh3.12330. eCollection 2020 Oct.
BACKGROUND/AIM: Inflammatory bowel disease (IBD) is said to be rare in Asian children, and there is scarce information from India. We therefore analyzed our experience of pediatric IBD.
Prospectively maintained data of 105 consecutive children [median age 12 (IQR:7-14) years, 71 males] with IBD from July 2001 through June 2016 were retrospectively analyzed. Their detailed clinical features, endoscopic appearance, histopathology, and treatment outcomes were recorded. For Crohn's disease (CD), disease phenotype and disease location were assessed as per Paris classification.
Disease spectrum includes ulcerative colitis (UC), 55 (52%); CD, 43 (41%); and IBD-unclassified, 7 (7%). There was a significant increase in the number of cases in the last 5 years compared to the previous 10 years (63 . 42, r = 0.96). Most UC cases (75%) had extensive/pancolitis, 74% of CD had colonic/ileocolonic disease, and 65% had inflammatory phenotype. Fever, growth failure, pain in abdomen, and need for surgery were significantly more frequent in CD than in UC ( < 0.0001). Over a median follow up of 19 (IQR: 7-48) months, remission was achieved in 48 of 51 (94%) UC patients and in 24 of 34 (70.6%) CD patients; an immunomodulator was required to maintain remission in 67% of UC cases. In CD, there was a significant reduction in the use of empirical antitubercular therapy (76%, = 0.008) with time, and disease progressed in three.
IBD is not uncommon, and the incidence seems to be increasing among Indian children. UC is more common than CD and is more often an extensive disease. CD is mainly an inflammatory phenotype. The majority of children with IBD required an immunomodulator to maintain remission.
背景/目的：炎症性肠病（IBD）在亚洲儿童中较为罕见，且来自印度的相关信息匮乏。因此，我们分析了我们在儿科IBD方面的经验。
回顾性分析了2001年7月至2016年6月期间连续收治的105例IBD儿童（中位年龄12岁，四分位间距：7 - 14岁，男性71例）的前瞻性维护数据。记录了他们详细的临床特征、内镜表现、组织病理学和治疗结果。对于克罗恩病（CD），根据巴黎分类评估疾病表型和疾病部位。
疾病谱包括溃疡性结肠炎（UC）55例（52%）；CD 43例（41%）；未分类的IBD 7例（7%）。与前10年相比，最近5年的病例数显著增加（63对42，r = 0.96）。大多数UC病例（75%）为广泛性/全结肠炎，74%的CD患者患有结肠/回结肠疾病，65%具有炎症表型。CD患者发热、生长发育迟缓、腹痛及手术需求显著高于UC患者（<0.0001）。中位随访19个月（四分位间距：7 - 48个月），51例UC患者中的48例（94%）和34例CD患者中的24例（70.6%）实现缓解；67%的UC病例需要使用免疫调节剂维持缓解。在CD患者中，经验性抗结核治疗的使用随时间显著减少（76%，P = 0.008），3例疾病进展。
IBD在印度儿童中并不罕见，发病率似乎在上升。UC比CD更常见，且更常为广泛性疾病。CD主要为炎症表型。大多数IBD儿童需要使用免疫调节剂维持缓解。
