Ronconi Monica S, Neuraz Antoine, Payen Elise, Nader Elie Abi, Lambe Cécile, Campeotto Florence, Talbotec Cécile, Ruemmele Frank M, Pigneur Bénédicte
Service de Gastro-Entérologie et Nutrition Pédiatrique, Centre de Référence Des Maladies Rares Digestives (MARDI), Assistance Publique-Hôpitaux de Paris, Hôpital Necker Enfants Malades, Université Paris Cité, Paris, France.
Department of Biostatistics, Imagine Institute, APHP, Paris, France.
Acta Paediatr. 2025 Sep;114(9):2329-2336. doi: 10.1111/apa.70115. Epub 2025 May 7.
Presence of deep ulcerations (DU) at diagnosis seems to be predictive of a more severe phenotype in adult Crohn's disease (CD). The aim of our study was to investigate if the presence of DU at diagnosis was associated with a more severe disease course over time in children.
In this monocentric retrospective study, we analysed data from paediatric patients with a new diagnosis of CD from 2009 to 2017. Clinical, laboratory data, treatments and complications were recorded for each patient at diagnosis and at 1, 3 and 5 years of follow-up. Patients were compared according to the presence or absence of DU on colonoscopy.
Among the 116 patients included in the study, 52 patients had DU at diagnosis. Comparison showed an increased risk for patients with DU to develop abdominal abscesses (p = 0.045) and to experience more relapses (p = 0.013) at 1 year. At 3 and 5 years, there was no longer any difference between groups. The time from diagnosis to first anti-TNF alpha was shorter in DU patients.
The presence of DU at diagnosis is associated with more complications during the first year of follow-up but not after, due to a more active therapeutic management.
在成人克罗恩病（CD）中，诊断时存在深部溃疡（DU）似乎预示着更严重的表型。我们研究的目的是调查儿童CD患者诊断时存在DU是否与随时间推移更严重的病程相关。
在这项单中心回顾性研究中，我们分析了2009年至2017年新诊断为CD的儿科患者的数据。记录每位患者诊断时以及随访1年、3年和5年时的临床、实验室数据、治疗情况和并发症。根据结肠镜检查时是否存在DU对患者进行比较。
在纳入研究的116例患者中，52例患者诊断时存在DU。比较显示，存在DU的患者在1年时发生腹部脓肿的风险增加（p = 0.045），复发次数更多（p = 0.013）。在3年和5年时，两组之间不再有任何差异。DU患者从诊断到首次使用抗TNF-α的时间较短。
诊断时存在DU与随访第一年期间更多的并发症相关，但在那之后则不然，这是由于更积极的治疗管理。
