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616.34-002-053.2 (1) |
Patologia sistemului digestiv. Tulburări ale tubului alimentar (1698) |
SM ISO690:2012 TIGHINEANU, Olga. Maladies inflammatoires intestinales aux enfants dans le cadre de la classification de Paris 2010. In: Buletin de Perinatologie, 2015, nr. 3(67), pp. 30-36. ISSN 1810-5289. |
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Buletin de Perinatologie | |||||
Numărul 3(67) / 2015 / ISSN 1810-5289 | |||||
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CZU: 616.34-002-053.2 | |||||
Pag. 30-36 | |||||
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Background. Diagnosis of inflammatory bowel diseases (IBD), including subtypes of ulcerative colitis, Crohn's disease and unspecified colitis remains uncertain, but according to several international guidelines diagnosis is based on clinical manifestations, endoscopic examination and histologic evaluation of bowel mucosa. The onset and evolution of inflammatory bowel diseases in children are highlighted by several atypical phenotypes, thus the Paris classifi cation, 2010 clearly defines the subtypes of inflammatory bowel disease, pointing out the diagnosis shortcomings ensuring correct diagnosis, phenotypic evolution, but also prognosis which allows a personalized and rational therapeutic conduct. Purpose. To evaluate the evolutionary phenotypic features of inflammatory bowel diseases, Crohn’s disease and ulcerative colitis in children in the Republic of Moldova in comparison with other European centers, in the context of the Paris classification, 2010. Material and methods. The research was based on a prospective study, which included all patients hospitalized in the Department of Gastroenterology, PMSI Mother and Child Institute, during 2010 and 2014, with the diagnosis of UC or CD, established as a result of history taking, clinical examination, laboratory tests, endoscopic and histological examination, stratified according to the Paris classification, 2010. Results. There were included 51 children with infl ammatory bowel diseases in our study. Of them, 45 (88.23%) with ulcerative colitis and 6 (11.76%) with Crohn’s disease, aged between 4 months and 17 years. Patients with Crohn’s disease, by criterion A (age), 4 (66.67%) children were included in criterion A1a and 2 (33.34%) children in criterion A1b, data similar to other European centers, being predominant in children older than 10 years. Colonic location was estimated in 66.67% (4/6) (L2), while ileocolonic location in 33.34% (2/6), as other regions without a certain location dominant as a whole. Crohn`s disease pattern in all national children is non-stenosing and non-penetrating (B1), being characterized by lack of perineal damage. Stature-weight retardation acounted for 83.34% of cases. Children with ulcerative colitis in the Republic of Moldova are characterized by the same process extension, pancolitis being the most common (E4 - proximal to the hepatic flexure) in 64.45% of cases, left colitis (E2 - distal to the splenic fl exure ) in 24.39% of cases, and extensive colitis (E3 - distal to the hepatic fl exure) 8.9% of cases, and finally proctitis (E1) in 4.45% of cases. The severity rate assessed according to pediatric activity index (PUCAI) was estimated in 82.3% of cases. Conclusions. According to the Paris classifi cation, 2010, Crohn’s disease, in children in the Republic of Moldova, is characterized by criteria similar to other European centers, such as age (A1a, A1b), location (L), retardation (G), but it is marked by a non-stenosing and non-penetrating (B1) pattern, as well as cases of ulcerative colitis do not diverge from other European centers, localization criterion (E), while the severity of the disease is noticeable especially in national children. |
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Cuvinte-cheie Crohn's disease, ulcerative colitis, children., Paris classification, 2010 |
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