Features of the course of Crohn's disease in young children
DOI:
https://doi.org/10.15574/SP.2025.5(149).3140Keywords:
young children, inflammatory bowel disease, Crohn’s disease, diagnosisAbstract
Over the past decades, the incidence of Crohn’s disease (CD) among young children has been steadily increasing worldwide. The complexity of managing such patients is due both to the severe and treatment-resistant course of the disease and to the specific features of its intestinal and extraintestinal manifestations.
Aim - to determine the clinical and paraclinical features of the course, the frequency and structure of extraintestinal manifestations, and the role of psychosomatic triggers in the initiation and severity of Crohn’s disease in young children at the present stage.
Materials and methods. 17 children from 0 to 3 years of age with CD were examined. Clinical-anamnestic, laboratory, ultrasound, endoscopic, and pathomorphological research methods were used.
Results. In the vast majority of children, the course of CD was severe (64.7%) or moderate (35.3%), with involvement of all segments of the intestine. Follow-up during treatment showed insufficient effectiveness of protocol corticosteroid therapy in 47.1% of patients. At the early stage of the disease, only 23.5% of the examined patients had clear clinical, laboratory, endoscopic, and morphological signs of CD; therefore, in most cases, the initial diagnosis was Unclassified form of Inflammatory Bowel Disease (IBD-U), which complicated the choice of treatment strategy and the monitoring of its effectiveness. More than 90% of young children with CD had extraintestinal manifestations and complications, including 58.8% of patients with three or more extraintestinal manifestations. The most common among them were anemia, protein-energy malnutrition, and growth retardation. The most frequent external triggers of CD in early childhood were severe respiratory and intestinal infections, coronavirus infection, and food allergy, on the background of genetic predisposition.
Conclusions. In most young children, CD is characterized by high inflammatory activity and involvement of all segments of the intestine in the pathological process. Children with IBD-U require regular examinations to clarify the nosological form of IBD as quickly as possible. The high frequency of extraintestinal manifestations of CD in young children confirms the need for medical management involving a multidisciplinary team of specialists.
The study was conducted in accordance with the principles of the Declaration of Helsinki. The study protocol was approved by the Bioethics Committee of the mentioned institution. Informed consent was obtained from all participants.
The authors declare no conflict of interest.
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