Ülseratif Kolit Tanılı Olgularımızın Retrospektif Olarak Değerlendirilmesi

Year 2012, Volume: 10 Issue: 2, 17 - 23, 01.09.2012

Fatih Ünal , Gülseren Şahin Ayşegül Cebe Semin Ayhan Filiz Eren Erhun Kasırga

Abstract

Gi rifl: İnflamatuvar barsak hastalıkları İBH , gastrointestinal kanalın remisyon ve alevlenmeler ile seyreden kronik inflamatuvar hastalıklarıdır. Çalışmamızda İBH tanısı ile izlediğimiz hastaların klinik ve laboratuvar özelliklerinin geriye dönük olarak değerlendirilmesi amaçlanmıştır. Gereç ve Yöntem: Çocuk gastroenteroloji bölümlerimizce 7 yıldır İBH tanısı ile izlemleri yapılan 18 hastanın başvuru yakınmaları, demografik özellikleri ve beraberinde bulunan hastalıklar kayıtlardan incelendi. Fizik bakıda saptanan olağan dışı bulgular endoskopik bulgular, histopatolojik bulgular ve uygulanan tedaviler gözden geçirildi. Bulgular: Çalışmamıza alınan 18 hastanın tanı yaşı ortalamaları 13,6±2,9 yıl 10K, 8E ve semptomların başlangıcından tanıya kadar geçen süre ortalama 6,9±4,5 aydı. Onyedi hasta ülseratif kolit ÜK ve bir hasta da intermediate kolit İK tanısı almıştı. İki hastada %11 hastalık açısından pozitif aile öyküsü vardı. Tanı anında en sık başvuru yakınmaları karın ağrısı %100 , kanlı ishal %94,5 ve tenezm %44,4 olarak bulundu. Laboratuvar bulgularından CRP pozitifliği %89 , sedimantasyon yüksekliği %83,3 ve demir eksikliği anemisi DEA %77,7 en sık rastlanan bulgulardı. Kolonoskopik olarak en sık pankolit %66,6 tutulumuna rastlandı. İBH’na eşlik eden diğer hastalıklar ise ailevi Akdeniz ateşi FMF %11 , çölyak hastalığı ÇH %5,5 ve Helikobakter pylori gastriti Hp %11 olarak bulundu. Pankolit tutulumu olan medikal tedaviye yanıtsız bir hastamıza %5,5 ise kolektomi uygulandı. Sonuç: Ülkemizde çocukluk çağında İBH tanısı alan hasta sayısı her geçen gün artmaktadır. Yine de nonspesifik semptomlar ile seyreden hastaların tanınması güç olabilmekte ve tanı gecikmelerine neden olabilmektedir. İBH’nın otoimmün hastalıklar ile birlikteliği nedeniyle uygun tedaviye rağmen remisyon sağlanamayan hastalarda gastrointestinal inflamasyonla giden FMF gibi hastalıklar da araştırılmalıdır. Gün cel Pe di at ri 2012; 10: 17-23

Keywords

İnflamatuvar barsak hastalığı, ülseratif kolit, remisyon

Retrospective Evaluation of Cases Diagnosed with Ulcerative Colitis

Abstract

In tro duc ti on: Inflammatory bowel disease IBD is a chronic inflammatory disease of thegastrointestinal canal characterised by remissions and exacerbations. This study aimedto make a retrospective evaluation of clinical and laboratory findings of patients beingmonitored with a diagnosis of IBD.Materials and Methods: Medical records of 18 patients with a diagnosis of IBD and 7years of follow-up at our pediatric gastroenterology departments were investigatedwith respect to demographic data, complaints on presentation and accompanyingdiseases. Unusual findings from physical examination, endoscopic findings,histopathological findings and the applied treatments were examined.Results: The 18 patients 10 female, 8 male included in this study had a mean age of13.6±2.9 years and the mean time from onset of symptoms to diagnosis was 6.9±4.5months. Seventeen patients were diagnosed with ulcerative colitis and 1 patient withintermediate colitis. There was a positive family history of the disease in 2 patients 11% . At the time of diagnosis, the most common complaints on presentation werefound to be abdominal pain 100% , bloody diarrhea 94.5% and tenesmus 44.4% . Themost frequent laboratory findings were CRP positivity 89% , increased sedimentationrate 83.3% and iron-deficient anaemia 77.7% . On colonoscopy, pancolitisinvolvement 66.6% was most frequently encountered. Accompanying diseases to IBD were found to be familialMediterranean fever FMF 11% , celiac disease 5.5% and Heliobacter pylori gastritis 5.5% . One patient 5.5% who didnot respond to medical treatment for pancolitis involvement underwent a colectomy. Discussion: The number of diagnoses of IBD in childhood is gradually increasing. Nonetheless, it can be difficult to define diseaseswith non-specific symptoms and this may cause a delay in diagnosis. Because of the association of autoimmune diseases withIBD, despite appropriate therapy, diseases with no remission which lead to gastrointestinal inflammation, such as FMF, should be further investigated. Jo ur nal of Cur rent Pe di at rics 2012; 10: 17-23

Keywords

Inflammatory bowel disease, ulcerative colitis, remission

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