COMPARATIVE CHARACTERISTICS OF DIFFERENT TYPES OF INFLAMMATORY BOWEL DISEASE IN CHILDREN
Abstract
Background. Inflammatory bowel disease (IBD) is a group of idiopathic, chronic, relapsing inflammatory conditions of the gastrointestinal tract including ulcerative colitis (UC), Crohn's disease (CD), and unspecified colitis (UnC). Objective. To provide a comparative characteristic of clinical and laboratory features of various IBD types in children according to the morphology, and to identify clinical and laboratory markers of unspecified colitis in children. Material and methods. 118 pediatric patients diagnosed with chronic inflammatory bowel disease were observed. Statistical processing of clinical and laboratory data was carried out using the statistical package R, version 4.1. Results. A comprehensive examination revealed 36 patients with Crohn's disease (CD), 54 those with ulcerative colitis (UC), and 28 with UnC. It was found out that in patients diagnosed with unspecified colitis, clinical manifestations were statistically more often observed at an earlier age (28,5 months [8; 50]) in contrast to children with UC (31 months [14; 122]) and CD patients (96 months [34,5;132]) (p=0,004). All patients with IBD had significant changes in stool frequency (from 3 to 9 or more times per day), 45 (83.3%) patients with UC having blood in stool (p <0.001). Pain syndrome was less common in patients diagnosed with UnC – 22 (78,6%) (p=0,048). The two clinical and laboratory symptoms were significantly more often observed in the group of patients with UC: protein-energy malnutrition (PEM) – 24 (44,4%)(p=0.008) and anemia – 39 (72,2%) (p<0.001). Patients diagnosed with UnC had a lower platelet count (292±68) (p=0.005). CD patients had a lower mean relative lymphocyte count (30,8%) (p=0.005). The level of C-reactive protein (CRP) was significantly more often elevated in patients with UC – 30 (55,6%) (p=0,005). Conclusions. Though standard methods used for examining patients with IBD allow us to establish the diagnoses of UC and CD, such examination is not sufficient for children with UnC. It is necessary to include new molecular genetic criteria in the examination protocol for patients with IBD, which will make it possible to offer appropriate treatment at an early stage of the disease.
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