MORPHOLOGICAL CRITERIA FOR PREDICTION OF SEVERITY OF CROHN’S DISEASE CLINICAL COURSE IN CHILDREN

Aim: to establish prognostic morphological criteria of complicated clinical course of Crohn’s disease in children. Patients and methods: morphometric and histological characteristics of the mucous membrane of the large intestine were studied in 27 patients with colitis form of Crohn’s disease on the...

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Main Authors: E. N. Fedulova, E. A. Zhukova, O. A. Tutina, T. A. Kuznetsova, O. V. Shumilova, O. V. Fedorova
Format: Article
Language:English
Published: "Paediatrician" Publishers LLC 2013-09-01
Series:Вопросы современной педиатрии
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Online Access:https://vsp.spr-journal.ru/jour/article/view/291
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Summary:Aim: to establish prognostic morphological criteria of complicated clinical course of Crohn’s disease in children. Patients and methods: morphometric and histological characteristics of the mucous membrane of the large intestine were studied in 27 patients with colitis form of Crohn’s disease on their first admission to a hospital. Results: the most informative predictive morphological criteria for unfavorable prognosis were the following: predominance of the non-active macrophages tending to aggregation in the lamina propria mucosae; destructive vasculitis; increase in the number of fibroblastic cells with the prevalence of the young forms. Non-active macrophages and immature fibroblasts under hypoxia conditions, associated with necrotizing vasculitits, are the factors which contribute to development of fibrosis in the mucous membrane of the large intestine. Conclusitons: unfavorable prognostic morphological criteria of Crohn’s disease were determined. These criteria allow using more aggressive treatment management («top-down» scheme) with early administration of steroid, cytostatic and anti-cytokine drugs in order to prevent the development of complications due to intestinal fibrosis.
ISSN:1682-5527
1682-5535