Хвороба Крона в дітей раннього віку. Складний шлях до діагнозу

Abstract

Inflammatory bowel diseases (IBD) is a group of chronic diseases characterized by destructive non-specific immune inflammation of the intestinal wall. The main forms include Crohn's disease and ulcerative colitis. Currently, Crohn's disease is one of the most urgent problems of children's gastroenterology, which is due to the annual increase in morbidity, "rejuvenation" of the pathological process, difficulties of diagnosis treatment, and high risk in developing of complications. IBDs with very early onset of manifestation have an atypical or erased clinical picture, which makes timely diagnosis in this age group of patients much more difficult. Purpose - to describe own clinical observation of a case of Crohn's disease with a very early onset. Clinical case. Was presented an observation of a patient of 2 years and 7 months old with Crohn’s disease the feature of which was a severe course with pronounced lesion of the gastrointestinal tract. The results of clinical data, laboratory, instrumental and histological methods of research, the complex stages of diagnosing of Crohn’s disease, as well as the issues of the patient’s treatment were discussed. The peculiarity of the described case was the early onset of the disease, continuously relapsing course, frequent acute respiratory diseases accompanied with diarrheal syndrome, absence of some specific complaints and changes in biochemical and immunological tests, corticosteroid dependence and severe extraintestinal manifestations of Crohn’s disease (anemia of a mixed nature). The diagnosis of Crohn’s disease was made at the age of 1year and 9 months (1 year and 4 months after the appearance of the first symptoms), which was confirmed a year later after a repeat examination. Late diagnosis was caused by the variety of clinical manifestations, absence of clear symptoms of the disease at the first stages of observation. The research was carried out in accordance with the principles of the Declaration of Helsinki, informed consent of the child's parents was obtained for the research. No conflict of interests was declared by the authors.