@article {1850, title = {Upper gastrointestinal involvement in paediatric onset Crohn{\textquoteright}s disease: prevalence and clinical implications.}, journal = {J Crohns Colitis}, volume = {6}, year = {2012}, month = {2012 Feb}, pages = {51-5}, abstract = {

BACKGROUND AND AIMS: Our study evaluated the prevalence, the characteristics and implications of the upper gastrointestinal localisation (UGI+) in paediatric Crohn{\textquoteright}s Disease (CD) patients.

METHODS: This prospective study evaluated 45 newly diagnosed CD patients at diagnosis and follow up with respect to CD localisation.

RESULTS: All patients presented CD at the colon and/or ileum. In 24/45 patients (53.3\%, 12 F and 12 M) an UGI+ involvement was also found. UGI+ patients had a younger age of onset (10.9 years versus 12.6 years; P<0.05). PCDAI at diagnosis was significantly higher in the UGI+ (41 vs. 25 P<0.01). UGI+ patients were overall more symptomatic. Pancolitis and extraintestinal manifestations were also more frequent (19/24 (80\%) vs. 12/21 (57\%) P<0.01). Growth was more impaired at diagnosis in UGI+ patients. By the end of the follow-up (mean 3 years, range 2 to 4) no significant difference was found in PCDAI (17 in UGI+ patients vs. 11 in UGI- P=NS), or the number of relapses. Weight and growth catch-up in UGI+ patients were comparable to UGI- ones. However, UGI+ patients required a more aggressive therapeutic approach.

CONCLUSION: At least half of paediatric onset CD patients have an upper gastrointestinal localisation. UGI+ patients present an earlier onset and a more severe disease. The final outcome does not differ, but UGI+ patients require a more aggressive therapeutic approach.

}, keywords = {Adolescent, Age of Onset, Child, Crohn Disease, Female, Humans, Male, Prospective Studies, Upper Gastrointestinal Tract}, issn = {1876-4479}, doi = {10.1016/j.crohns.2011.06.013}, author = {Crocco, S and Martelossi, S and Giurici, N and Villanacci, V and Ventura, A} }