Mechanisms of development, diagnosis and conservative therapy of Crohn's disease in pediatric practice
DOI:
https://doi.org/10.15574/SP.2024.5(141).6672Keywords:
children, Crohn's disease, etiology, pathogenesis, clinical manifestation, treatmentAbstract
In recent years, the incidence of Crohn's disease has significantly increased among both adult and pediatric populations, currently standing at 58 per 100,000 individuals.
This study aims to investigate the primary etiopathogenetic features, diagnostic methods, and conservative treatment options for this condition in children, based on a comprehensive literature review.
It highlights the fundamental differences, including higher disease activity scores, more complicated course of the disease, with the involvement of other organs and systems in the pathological process, difficulty of diagnosis and resistance to treatment, adverse impact on the child's growth and development, presence of protein and energy deficiency manifestations, impaired of psychosocial functions and adaptation capabilities in both physical and social spheres. Among the main etiological and pathogenetic factors of the disease, the genomic theory, infectious theory, intestinal microbiome influence, imbalance of cytokine regulation with an increase in the content of pro-inflammatory cytokines and environmental factors are considered. On the basis of the conducted analysis, it was established that at the current stage, a significant spread of the inflammatory process is determined, which is diagnosed for one meter or more of digestive tract, with the formation of crypt-abscesses and the development of deep ulcers. The main clinical syndromes and complications that characterize the course of this disease and its features in children are described. Modern principles of diagnosis and conservative treatment of pathology are considered, in which the use of mesalazines and antibiotics is highlighted. It is emphasized the need to use enteral therapy and, in the absence of an effect from treatment, the need for a timely transition to the use of immunomodulators, biologics in the treatment regimen.
The authors declare that there is no conflict of interest concerning the publication of this article.
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