histopathological changes in anatomical distribution of inflammatory bowel disease in children a retrospective cohort study组织病理学变化的解剖分布儿童炎症性肠病的回顾性队列研究.pdfVIP

Tsang et al. BMC Pediatrics 2012, 12:162 /1471-2431/12/162 RESEARCH ARTICLE Open Access Histopathological changes in anatomical distribution of inflammatory bowel disease in children: a retrospective cohort study 2 2 3 1* Jessica Tsang , Sheena Sikora , Donald Spady and Wael El-Matary Abstract Background: Anatomical progression of pediatric inflammatory bowel disease is under-reported. The aim of this work was to examine possible changes in the anatomical distribution of IBD in pediatric patients at diagnosis and at follow up. Methods: In a retrospective cohort study, the medical records of children with inflammatory bowel disease were examined. Patients who had at least 2 endoscopic/colonoscopic examinations were included. Primary outcome was histopathological progression based on histopathological examination of biopsies taken during endoscopic and colonoscopic bowel examination. Factors predictive of disease progression were also examined. Results: A total of 98 patients fulfilled inclusion criteria (49 female, 54 with ulcerative colitis, range 2 – 17 years, mean age at diagnosis was 10.6 years, SD ± 3.67), the mean duration of follow up was 32.9 months (range 0.1 – 60 months, SD ± 8.54). In the ulcerative colitis group, 41% had disease progression and none of the examined variables (age, gender, laboratory markers, growth and disease activity at diagnosis) appeared to effect disease progression. In the Crohn’s disease group, 75% had disease progression. Girls (OR = 0.13, 95% CI 0.02 – 0.79) and patients with high erythrocytic sedimentation rate (OR=0.942, 95% CI 0.894 – 0.99) were predictive for disease progression. Conclusions: Despite maximum therapy, the majority of children with Crohn’s disease appeared to h