Med Bull Sisli Etfal Hosp. 2023; 57(1): 73-78 | DOI: 10.14744/SEMB.2022.32708

Ýnflamatuvar Baðýrsak Hastalýðý tanýlý çocuklarda ekstraintestinal sistem bulgularý

Zubeyr Kavcar¹, Hasret Ayyildiz Civan², Didem Gulcu Taskin³, Sadik Sami Hatipoglu^1
1Bakýrköy Dr. Sadi Konuk Eðitim ve Araþtýrma Hastanesi Çocuk Saðlýðý ve Hastalýklarý Kliniði, Ýstanbul
²Bakýrköy Dr. Sadi Konuk Eðitim ve Araþtýrma Hastanesi, Çocuk Gastroenteroloji Kliniði, Ýstanbul
³Adana Þehir ve Eðitim Hastanesi Çocuk Gastroenteroloji Kliniði, Adana

Amaç: Çalýþmamýzda Ýnflamatuvar Baðýrsak Hastalýðý (IBH) olan çocuklarda baðýrsak dýþý bulgularýn sýklýðýný ve bunun hastalýk aktivitesi, hastalýk tipi ve hastalýk yaþý ile korelasyonunu deðerlendirmeyi amaçladýk.
Metod: Çalýþmaya 18 yaþ altý, IBH tanýsý ile takip edilen hastalar dahil edildi. Hastalarýn demografik özellikleri, yaþlarý, cinsiyetleri, hastalýk tipleri ve taný konulan yaþlarý kayýt altýna alýndý. Çalýþmaya dahil edilen hastalarýn hastalýk aktivite indeksleri enson vizitlerinde yapýlan fizik muayene ve laboratuvar bulgularý kullanýlarak Ülseratif Kolit (ÜK) hastalarýnda Pediatrik Ülseratif Kolit Aktivite Ýndeksi, Crohn Hastalarýnda (CH) ise Pediatrik Crohn Hastalýðý Aktivite Ýndeksi kullanýlarak hesaplandý.
Sonuçlar: Çalýþmaya toplam 44 hasta dahil edildi, hastalarýn 40.9% (n = 18)’u kýz ve 59.1% (n=26)’i erkek idi. Hasta yaþlarý 8-19 arasýnda deðiþirken ortalama yaþ 14.64 ± 3.19 yýl idi. Hastalýk tipine göre hastalarýn 27.3%’ü CH ve 72.7%’si ÜK idi. Hastalýk aktivitesi deðerlendirildiðinde hastalarýn 37.2% remisyonda iken 37.2%’si hafif aktivasyon, 16.3%’ü orta aktivasyon ve 9.3%’ü ise ciddi aktivasyon mevcut idi. Hastalýk ile birlikte baðýrsak dýþý bulgularýn sýklýðý kýzlarda 77.8%, erkeklerde ise 65.4% idi. CH’de baðýrsak dýþý bulgu sýklýðý % 75 iken ÜK’de % 68,8 sýklýðýnda idi. Baðýrsak dýþý bulgularda en sýk karaciðer tutulumu (%41,5) sonra sýrasýyla eklem tutulumu (%29,5), osteoporoz (%7), osteopenia (%16,3), göz tutulumu (üveit) (%2.3), cilt tutulumu (eriteme noduzum) (%2,3) görüldü.
Tartýþma: Baðýrsak dýþý bulgular çocukluk IBH’lerde sýk görülmektedir. Bilindiðinin aksine baðýrsak dýþý bulgular ÜK hastalarýnda da CH’larýnda görüldüðü kadar sýk görülmektedir. (SETB-2022-10-229)

Anahtar Kelimeler: Ekstraintestinal bulgular, pediatrik inflamatuvar baðýrsak hastalýðý, pediatrik ülseratif kolit, pediatrik crohn hastalýðý

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Extraintestinal Manifestations in Children Diagnosed with Inflammatory Bowel Disease

Zubeyr Kavcar¹, Hasret Ayyildiz Civan², Didem Gulcu Taskin³, Sadik Sami Hatipoglu^1
1Department of Pediatrics, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Ýstanbul, Türkiye
²Department of Pediatric Gastroenterology, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Ýstanbul, Türkiye
³Department of Pediatric Gastroenterology, Adana City Training and Research Hospital, Adana, Türkiye

Objectives: We aimed to evaluate the frequency of extraintestinal manifestations (EIM) in children with inflammatory bowel disease (IBD) and the correlation of EIM with disease activity index, disease type and disease age.
Methods: Records of patients who were under the 18 years of age and followed up with the diagnosis of IBD were included in the study. The demographic characteristics of the patients, the age of the patients, the sex of the patients, the type of disease and the age of the disease were recorded. When patients were enrolled in the study disease activity indexes were calculated by examining the physical examination and laboratory values of the patients in their last visits, by using the Pediatric Ulcerative Colitis Activity Index (PUCAI) in Ulcerative Colitis (UC) and the Pediatric Crohn's Disease Activity Index (PCDAI) in Crohn's Disease (CD).
Results: It was conducted with a total of 44 patients, 40.9% (n=18) females and 59.1% (n=26) males diagnosed with IBD. The ages of the patients participating in the study ranged from 8 to 19 and the mean was found to be 14.64±3.19 years. According to the type of disease; 27.3% of the patients were CD and 72.7% were UC. When the disease activity is examined; 37.2% were in remission, 37.2% were mild, 16.3% moderate and 9.3% severe. The incidence of EIM in females is 77.8% and 65.4% in males. The incidence of EIM is 75% in CD and 68.8% in UC. Hepatobiliary involvement was detected in 41.5% (n=17) of the patients, joint involvement in 29.5% (n=13), osteopenia in bone in 16.3% (n=7), osteoporosis in 7% (n=3), ocular involvement (uveitis) in 2.3% (n=1) and skin involvement (erythema nodosum) in 2.3% (n=1).
Conclusion: EIM are common in childhood IBD patients. It should be kept in mind that EIM are as common in UC as CD.

Keywords: Extraintestinal manifestations, pediatric inflammatory bowel disease, pediatric ulcerative colitis, pediatric crohn's disease

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