Ömer Faruk BEŞER, Tufan KUTLU, Fügen Çullu ÇOKUĞRAŞ, Tülay ERKAN

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

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

Anahtar Kelimeler:

Crohn hastalığı, inflamatuvar barsak hastalığı, ülseratif kolit

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

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

Keywords:

Crohn’s disease, inflammatory bowel disease, ulcerative colitis,

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