P009 Autologous Bone Marrow Transplantation in Refractory Crohn's Disease: A Case Report.

Abstract

BACKGROUND: IBD comprises Crohn ́s disease (CD) and ulcerative colitis (UC), both are characterized by unpredictable exacerbations and remissions. The incidence is highest in adolescence and early adulthood, and alike other chronic disease, have a considerable impact upon patients' HRQoL. Few studies assessing HRQoL have been performed in adolescents and young adults (AYA) populations.Our objectives were to assess the health-related quality of life (HRQoL) in AYA patients with inflammatory bowel disease (IBD) and analyze the diseases factors that could influence it. METHODS: 59 AYA IBD patients (13-25y) at two gastroenterology units of tertiary hospitals was evaluated and compared to 60 AYA healthy controls (13-25y). 59 AYA IBD patients completed the Pediatric Quality of Life Inventory 4.0 (PedsQL4.0), Short Form Health Survey (SF-36) questionnaires and Pain Visual Scale, according to age. After we compared HRQoL between Crohn’s disease (CD) vs. UC (ulcerative colitis) in AYA population. The demographic data, extra-intestinal manifestation, overlap syndromes, disease active status, treatment and outcomes were also evaluated. All participants and the adolescents' legal guardian written informed consent form. RESULTS: PedsQL4.0 domain "school/ work" and SF-36 domain "general health perception" was reduced in IBD AYA patients compared with healthy controls (P < 0.05). In addition, significantly lower score “health change” in SF-36 in comparison with healthy determined perceived differences in state of health over the past year. No difference in other’s domains and pain scale was observed between CD and UC AYA patients. Disease activity as well extra intestinal manifestations, overlap syndromes, treatments and outcomes did not influence the HRQoL of the AYA patients. Autoimmune sclerosing cholangitis and the use of prednisone were significantly higher among UC patients, whereas previous gut surgery was higher between CD patients. However, these disease factors did not significantly influence the HRQoL between CD vs UC. Mann-Whitney test and Fisher's test were used to compare continuous variables and comparison between groups, P-values were set at 5% (P < 0.05). CONCLUSION: HRQoL was significant lower for AYA with IBD relative to healthy controls. This result highlights areas to focus clinical attention in adolescents and young adult patients with IBD for assessment and future interventions.