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İnflamatuvar Barsak Hastalığı Tanılı Çocukların Uzun Süreli İzlemi: 53 Olgunun Değerlendirilmesi

Yıl 2015, Cilt: 13 Sayı: 2, 81 - 88, 01.09.2015
https://doi.org/10.4274/jcp.27247

Öz

Giriş: Bu çalışmada inflamatuvar barsak hastalığı İBH tanısı ile izlenen çocukların uzun dönem demografik, klinik, laboratuvar, tedaviye yanıt özelliklerinin belirlenmesi amaçlanmıştır. Gereç ve Yöntem: Çalışmaya 0-18 yaş aralığında İBH tanısı ile izlenmekte olan 53 olgu dahil edilmiştir. Hasta grubu; klinik, serolojik, endoskopik, histopatolojik ölçütlere göre İBH tanısı konulan hastaları içermiştir. Hastaların doğum tarihleri, özofagogastroduodenoskopi/kolonoskopi bulguları, tanı anındaki ve izlem sırasındaki laboratuvar tetkikleri, yakınmaları ve süreleri, daha önce almış olduğu ve şu an almakta olduğu tedaviler ve eşlik eden hastalık varlığı gözden geçirilmiştir. Tanı anındaki ve tedavi sonrasındaki boy ve vücut ağırlığı Z skorları hesaplanıp karşılaştırılmıştır. Hastaların fizik muayene bulguları ile ailede İBH ve otoimmün hastalık öyküleri sorgulanarak kayıt edilmiştir. Bulgular: Olgularımızın 18’i Crohn hastalığı CH , 35’i ülseratif kolit ÜK tanısı ile izlenmekteydi. Erkek/kız oranı CH’de 3,5/1, ÜK’de 1,33/1 idi. On olgunun %18,9 akrabalarından birisinde İBH tanılı başka bir hasta bulunmaktaydı ve bu olgularda yakınma başlama yaş ortalamasının ailesinde İBH olmayanlardan istatistiksel olarak anlamlı derecede düşük olduğunu saptadık p=0,042 . Olguların 20’sinin %37,8 anne babaları arasında akrabalık olduğunu tespit ettik. Akrabalık saptanan 20 olgunun yakınma başlama yaş ortalamasının akrabalık olmayanlardan istatistiksel olarak anlamlı derecede düşük olduğunu gözlemledik p=0,025 . Yaşa göre ağırlık Z skoru %18,9 olguda -2’nin altındaydı ve bu olguların yedisi CH tanısı ile izlenmekteydi. Yaşa göre boy Z skoru %17 olguda -2’nin altındaydı ve bu olguların dokuzu yine CH tanısı ile takip edilmekteydi. Tanı anındaki beyaz küre sayılarının, eritrosit çökme hızının ve C-reaktif protein değerlerinin tedavi sonrasında istatistiksel olarak anlamlı derecede gerilediği gözlenmiştir p

Kaynakça

  • 1. Loftus EV Jr. Clinical epidemiology of inflammatory bowel disease: Incidence, prevalence, and environmental influences. Gastroenterology 2004;126:1504-17.
  • 2. Loftus EV Jr, Schoenfeld P, Sandborn WJ. The epidemiology and natural history of Crohn’s disease in population-based patient cohorts from North America: a systematic review. Aliment Pharmacol Ther 2002;16:51-60.
  • 3. Ehlin AG, Montgomery SM, Ekbom A, Pounder RE, Wakefield AJ. Prevalence of gastrointestinal disease in two British national birth cohorts. Gut 2003;52:1117-21.
  • 4. Wellcome Trust Case Control Consortium. Genome-wide association study of 14,000 cases of seven common diseases and 3,000 shared controls. Nature 2007;447:661-78.
  • 5. Mizoguchi A, Mizoguchi E. Inflammatory bowel disease, past, present and future: lessons from animal models. J Gastroenterol 2008;43:1-17.
  • 6. Glocker EO, Kotlarz D, Boztug K, Gertz EM, Schäffer AA, Noyan F, et al. Inflammatory bowel disease and mutations affecting the interleukin-10 receptor. N Engl J Med 2009;361:2033-45.
  • 7. Moore KW, de Waal Malefyt R, Coffman RL, O’Garra A. Interleukin-10 and the interleukin-10 receptor. Annu Rev Immunol 2001;19:683-765.
  • 8. Kühn R, Löhler J, Rennick D, Rajewsky K, Müller W. Interleukin-10-deficient mice develop chronic enterocolitis. Cell 1993;75:263-74.
  • 9. Beser OF, Conde CD, Serwas NK, Cokugras FC, Kutlu T, Boztug K, et al. Clinical Features of interleukin-10 receptor gene mutations in children with very early-onset inflammatory bowel disease. J Pediatr Gastroenterol Nutr 2015;60:332-8.
  • 10. Aydoğdu S. İnflamatuvar bağırsak hastalıkları epidemiyolojisi ve genetiği. İçinde: Erkan T, editor. İnflamatuvar bağırsak hastalıkları 2011 bahar okulu kurs kitabı; 2011:5-14.
  • 11. Ünal F, Şahin G, Cebe A, Ayhan S, Eren F, Kasırga E. Ülseratif kolit tanılı olgularımızın retrospektif olarak değerlendirilmesi. Güncel Pediatri 2012;10:17-23.
  • 12. Diefenbach KA, Breuer CK. Pediatric inflammatory bowel disease. World J Gastroenterol 2006;12:3204-12.
  • 13. Kugathasan S, Judd RH, Hoffmann RG, Heikenen J, Telega G, Khan F, et al. Epidemiologic and clinical characteristics of children with newly diagnosed inflammatory bowel disease in Wisconsin: a statewide population-based study. J Pediatr 2003;143:525-31.
  • 14. Vernier-Massouille G, Balde M, Salleron J, Turck D, Dupas JL, Mouterde O, et al. Natural history of pediatric Crohn’s disease: a population-based cohort study. Gastroenterology 2008;135:1106- 13.
  • 15. Benchimol EI, Guttmann A, Griffiths AM, Rabeneck L, Mack DR, Brill H, et al. Increasing incidence of paediatric inflammatory bowel disease in Ontario, Canada: evidence from health administrative data. Gut 2009;58:1490-7.
  • 16. Castro M, Papadatou B, Baldassare M, Balli F, Barabino A, Barbera C, et al. Inflammatory bowel disease in children and adolescents in Italy: data from the pediatric national IBD register (1996-2003). Inflamm Bowel Dis 2008;14:1246-52.
  • 17. IBD Working Group of the European Society for Paediatric Gastroenterology, Hepatology and Nutrition. Inflammatory bowel disease in children and adolescents: recommendations for diagnosis--the Porto criteria. J Pediatr Gastroenterol Nutr 2005;41:1-7.
  • 18. Halme L, Paavola-Sakki P, Turunen U, Lappalainen M, Farkkila M, Kontula K. Family and twin studies in inflammatory bowel disease. World J Gastroenterol 2006;12:3668-72.
  • 19. Sawczenko A, Sandhu BK. Presenting features of inflammatory bowel disease in Great Britain and Ireland. Arch Dis Child 2003;88:995-1000.
  • 20. Lichtenberger GS, Flavell RA, Alexopoulou L. Innate immunity and apoptosis in IBD. Inflamm Bowel Dis 2004;10(Suppl 1):58-62.
  • 21. McDermott MF. A common pathway in periodic fever syndromes. Trends Immunol 2004;25:457-60.
  • 22. Griffiths AM, Nguyen P, Smith C, MacMillan JH, Sherman PM. Growth and clinical course of children with Crohn’s disease. Gut 1993;34:939-43.
  • 23. Motil KJ, Grand RJ, Davis-Kraft L, Ferlic LL, Smith EO. Growth failure in children with inflammatory bowel disease: a prospective study. Gastroenterology 1993;105:681-91.
  • 24. Ceballos C. Growth and early onset inflammatory bowel disease. Gastroenterol Nurs 2008;31:101-4.
  • 25. Kelts DG, Grand RJ, Shen G, Watkins JB, Werlin SL, Boehme C. Nutritional basis of growth failure in children and adolescents with Crohn’s disease. Gastroenterology 1979;76:720-7.
  • 26. Cabrera-Abreu JC, Davies P, Matek Z, Murphy MS. Performance of blood tests in diagnosis of inflammatory bowel disease in a specialist clinic. Arch Dis Child 2004;89:69-71.
  • 27. Goodhand JR, Kamperidis N, Rao A, Laskaratos F, McDermott A, Wahed M, et al. Prevalence and management of anemia in children, adolescents, and adults with inflammatory bowel disease. Inflamm Bowel Dis 2012;18:513-9.
  • 28. Khan K, Schwarzenberg SJ, Sharp H, Greenwood D, WeisdorfSchindele S. Role of serology and routine laboratory tests in childhood inflammatory bowel disease. Inflamm Bowel Dis 2002;8:325-9.
  • 29. Kim JE, Kim KS, Seo JK. Diagnostic role of anti-Saccharomyces cerevisiae and antineutrophil cytoplasmic autoantibodies in pediatric inflammatory bowel disease. Korean J Gastroenterol 2003;42:297-302.
  • 30. Jakobsen C, Munkholm P, Paerregaard A, Wewer V. Steroid dependency and pediatric inflammatory bowel disease in the era of immunomodulators--a population-based study. Inflamm Bowel Dis 2011;17:1731-40.
  • 31. Turner D. Relapsing and refractory ulcerative colitis in children. Dig Dis 2014;32:419-26.
  • 32. Lestár B, Nagy F. Surgical management of inflammatory bowel diseases. Orv Hetil 2004;145:51-8.

Long-Term Follow-Up of Children with Inflammatory Bowel Disease: Evaluation of 53 Cases

Yıl 2015, Cilt: 13 Sayı: 2, 81 - 88, 01.09.2015
https://doi.org/10.4274/jcp.27247

Öz

Introduction: In this study it was aimed to determine the long-term demographic, clinical and laboratory characteristics, together with the responses to therapy, in children diagnosed with inflammatory bowel disease IBD .Materials and Methods: Fifty-three cases, aged 0 to 18 years, followedup with the diagnosis of IBD were included in this study. The study groupconsisted of patients diagnosed as IBD according to clinical, serologic, endoscopic and histopathological criteria. Dates of birth, esophagogastroduodenoscopy/colonoscopy findings, laboratory results at the time of diagnosis and during follow-up, complaints and their durations, treatments received presently and previously and comorbid diseases were documented. Patients’ heights, weights and Z scores at the time of diagnosis and following treatment were documented, calculated and compared. Family history of IBD and autoimmune disorders were questioned and recorded together with physical examination findings. Results: Among our cases, 18 were followed up with the diagnosis of Crohn’s disease CD and 35 had the diagnosis of ulcerative colitis UC . Male to female ratio was 3.5/1 in CD and 1.33/1 in UC. Ten cases 18.9% had the history of having a relative with IBD in their families. Mean age for start of complaints of this group was statistically significantly lower than the group having no family history of IBD p=0.042 . Twenty of the cases 37.8% had history of consanguinity between parents. Mean age for start of complaints of this group, whose parents were consanguine, was statistically significantly lower than the group with non-related parents p=0.025 . Weight-for-age Z-score was below -2 in 18.9% of cases and seven of them were diagnosed with CD. Height-forage Z-score was below -2 in 17% of cases and nine of them were also followed-up with the diagnosis of CD. The white blood cell count, erythrocyte sedimentation rate and C-reactive protein value at the time of diagnosis were statistically significantly decreased following treatment p

Kaynakça

  • 1. Loftus EV Jr. Clinical epidemiology of inflammatory bowel disease: Incidence, prevalence, and environmental influences. Gastroenterology 2004;126:1504-17.
  • 2. Loftus EV Jr, Schoenfeld P, Sandborn WJ. The epidemiology and natural history of Crohn’s disease in population-based patient cohorts from North America: a systematic review. Aliment Pharmacol Ther 2002;16:51-60.
  • 3. Ehlin AG, Montgomery SM, Ekbom A, Pounder RE, Wakefield AJ. Prevalence of gastrointestinal disease in two British national birth cohorts. Gut 2003;52:1117-21.
  • 4. Wellcome Trust Case Control Consortium. Genome-wide association study of 14,000 cases of seven common diseases and 3,000 shared controls. Nature 2007;447:661-78.
  • 5. Mizoguchi A, Mizoguchi E. Inflammatory bowel disease, past, present and future: lessons from animal models. J Gastroenterol 2008;43:1-17.
  • 6. Glocker EO, Kotlarz D, Boztug K, Gertz EM, Schäffer AA, Noyan F, et al. Inflammatory bowel disease and mutations affecting the interleukin-10 receptor. N Engl J Med 2009;361:2033-45.
  • 7. Moore KW, de Waal Malefyt R, Coffman RL, O’Garra A. Interleukin-10 and the interleukin-10 receptor. Annu Rev Immunol 2001;19:683-765.
  • 8. Kühn R, Löhler J, Rennick D, Rajewsky K, Müller W. Interleukin-10-deficient mice develop chronic enterocolitis. Cell 1993;75:263-74.
  • 9. Beser OF, Conde CD, Serwas NK, Cokugras FC, Kutlu T, Boztug K, et al. Clinical Features of interleukin-10 receptor gene mutations in children with very early-onset inflammatory bowel disease. J Pediatr Gastroenterol Nutr 2015;60:332-8.
  • 10. Aydoğdu S. İnflamatuvar bağırsak hastalıkları epidemiyolojisi ve genetiği. İçinde: Erkan T, editor. İnflamatuvar bağırsak hastalıkları 2011 bahar okulu kurs kitabı; 2011:5-14.
  • 11. Ünal F, Şahin G, Cebe A, Ayhan S, Eren F, Kasırga E. Ülseratif kolit tanılı olgularımızın retrospektif olarak değerlendirilmesi. Güncel Pediatri 2012;10:17-23.
  • 12. Diefenbach KA, Breuer CK. Pediatric inflammatory bowel disease. World J Gastroenterol 2006;12:3204-12.
  • 13. Kugathasan S, Judd RH, Hoffmann RG, Heikenen J, Telega G, Khan F, et al. Epidemiologic and clinical characteristics of children with newly diagnosed inflammatory bowel disease in Wisconsin: a statewide population-based study. J Pediatr 2003;143:525-31.
  • 14. Vernier-Massouille G, Balde M, Salleron J, Turck D, Dupas JL, Mouterde O, et al. Natural history of pediatric Crohn’s disease: a population-based cohort study. Gastroenterology 2008;135:1106- 13.
  • 15. Benchimol EI, Guttmann A, Griffiths AM, Rabeneck L, Mack DR, Brill H, et al. Increasing incidence of paediatric inflammatory bowel disease in Ontario, Canada: evidence from health administrative data. Gut 2009;58:1490-7.
  • 16. Castro M, Papadatou B, Baldassare M, Balli F, Barabino A, Barbera C, et al. Inflammatory bowel disease in children and adolescents in Italy: data from the pediatric national IBD register (1996-2003). Inflamm Bowel Dis 2008;14:1246-52.
  • 17. IBD Working Group of the European Society for Paediatric Gastroenterology, Hepatology and Nutrition. Inflammatory bowel disease in children and adolescents: recommendations for diagnosis--the Porto criteria. J Pediatr Gastroenterol Nutr 2005;41:1-7.
  • 18. Halme L, Paavola-Sakki P, Turunen U, Lappalainen M, Farkkila M, Kontula K. Family and twin studies in inflammatory bowel disease. World J Gastroenterol 2006;12:3668-72.
  • 19. Sawczenko A, Sandhu BK. Presenting features of inflammatory bowel disease in Great Britain and Ireland. Arch Dis Child 2003;88:995-1000.
  • 20. Lichtenberger GS, Flavell RA, Alexopoulou L. Innate immunity and apoptosis in IBD. Inflamm Bowel Dis 2004;10(Suppl 1):58-62.
  • 21. McDermott MF. A common pathway in periodic fever syndromes. Trends Immunol 2004;25:457-60.
  • 22. Griffiths AM, Nguyen P, Smith C, MacMillan JH, Sherman PM. Growth and clinical course of children with Crohn’s disease. Gut 1993;34:939-43.
  • 23. Motil KJ, Grand RJ, Davis-Kraft L, Ferlic LL, Smith EO. Growth failure in children with inflammatory bowel disease: a prospective study. Gastroenterology 1993;105:681-91.
  • 24. Ceballos C. Growth and early onset inflammatory bowel disease. Gastroenterol Nurs 2008;31:101-4.
  • 25. Kelts DG, Grand RJ, Shen G, Watkins JB, Werlin SL, Boehme C. Nutritional basis of growth failure in children and adolescents with Crohn’s disease. Gastroenterology 1979;76:720-7.
  • 26. Cabrera-Abreu JC, Davies P, Matek Z, Murphy MS. Performance of blood tests in diagnosis of inflammatory bowel disease in a specialist clinic. Arch Dis Child 2004;89:69-71.
  • 27. Goodhand JR, Kamperidis N, Rao A, Laskaratos F, McDermott A, Wahed M, et al. Prevalence and management of anemia in children, adolescents, and adults with inflammatory bowel disease. Inflamm Bowel Dis 2012;18:513-9.
  • 28. Khan K, Schwarzenberg SJ, Sharp H, Greenwood D, WeisdorfSchindele S. Role of serology and routine laboratory tests in childhood inflammatory bowel disease. Inflamm Bowel Dis 2002;8:325-9.
  • 29. Kim JE, Kim KS, Seo JK. Diagnostic role of anti-Saccharomyces cerevisiae and antineutrophil cytoplasmic autoantibodies in pediatric inflammatory bowel disease. Korean J Gastroenterol 2003;42:297-302.
  • 30. Jakobsen C, Munkholm P, Paerregaard A, Wewer V. Steroid dependency and pediatric inflammatory bowel disease in the era of immunomodulators--a population-based study. Inflamm Bowel Dis 2011;17:1731-40.
  • 31. Turner D. Relapsing and refractory ulcerative colitis in children. Dig Dis 2014;32:419-26.
  • 32. Lestár B, Nagy F. Surgical management of inflammatory bowel diseases. Orv Hetil 2004;145:51-8.
Toplam 32 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Research Article
Yazarlar

Ömer Faruk Beşer Bu kişi benim

Tufan Kutlu Bu kişi benim

Fügen Çullu Çokuğraş Bu kişi benim

Tülay Erkan Bu kişi benim

Yayımlanma Tarihi 1 Eylül 2015
Yayımlandığı Sayı Yıl 2015 Cilt: 13 Sayı: 2

Kaynak Göster

APA Beşer, Ö. F., Kutlu, T., Çokuğraş, F. Ç., Erkan, T. (2015). İnflamatuvar Barsak Hastalığı Tanılı Çocukların Uzun Süreli İzlemi: 53 Olgunun Değerlendirilmesi. Güncel Pediatri, 13(2), 81-88. https://doi.org/10.4274/jcp.27247
AMA Beşer ÖF, Kutlu T, Çokuğraş FÇ, Erkan T. İnflamatuvar Barsak Hastalığı Tanılı Çocukların Uzun Süreli İzlemi: 53 Olgunun Değerlendirilmesi. Güncel Pediatri. Eylül 2015;13(2):81-88. doi:10.4274/jcp.27247
Chicago Beşer, Ömer Faruk, Tufan Kutlu, Fügen Çullu Çokuğraş, ve Tülay Erkan. “İnflamatuvar Barsak Hastalığı Tanılı Çocukların Uzun Süreli İzlemi: 53 Olgunun Değerlendirilmesi”. Güncel Pediatri 13, sy. 2 (Eylül 2015): 81-88. https://doi.org/10.4274/jcp.27247.
EndNote Beşer ÖF, Kutlu T, Çokuğraş FÇ, Erkan T (01 Eylül 2015) İnflamatuvar Barsak Hastalığı Tanılı Çocukların Uzun Süreli İzlemi: 53 Olgunun Değerlendirilmesi. Güncel Pediatri 13 2 81–88.
IEEE Ö. F. Beşer, T. Kutlu, F. Ç. Çokuğraş, ve T. Erkan, “İnflamatuvar Barsak Hastalığı Tanılı Çocukların Uzun Süreli İzlemi: 53 Olgunun Değerlendirilmesi”, Güncel Pediatri, c. 13, sy. 2, ss. 81–88, 2015, doi: 10.4274/jcp.27247.
ISNAD Beşer, Ömer Faruk vd. “İnflamatuvar Barsak Hastalığı Tanılı Çocukların Uzun Süreli İzlemi: 53 Olgunun Değerlendirilmesi”. Güncel Pediatri 13/2 (Eylül 2015), 81-88. https://doi.org/10.4274/jcp.27247.
JAMA Beşer ÖF, Kutlu T, Çokuğraş FÇ, Erkan T. İnflamatuvar Barsak Hastalığı Tanılı Çocukların Uzun Süreli İzlemi: 53 Olgunun Değerlendirilmesi. Güncel Pediatri. 2015;13:81–88.
MLA Beşer, Ömer Faruk vd. “İnflamatuvar Barsak Hastalığı Tanılı Çocukların Uzun Süreli İzlemi: 53 Olgunun Değerlendirilmesi”. Güncel Pediatri, c. 13, sy. 2, 2015, ss. 81-88, doi:10.4274/jcp.27247.
Vancouver Beşer ÖF, Kutlu T, Çokuğraş FÇ, Erkan T. İnflamatuvar Barsak Hastalığı Tanılı Çocukların Uzun Süreli İzlemi: 53 Olgunun Değerlendirilmesi. Güncel Pediatri. 2015;13(2):81-8.