Associations between the Presence of Granulomata and Disease Phenotype and Outcomes in Children Diagnosed with Crohn’s Disease
Background: The finding of a mucosal granuloma on histological analysis of endoscopically obtained biopsies in children with Crohn’s disease has been suggested to provide prognostic information. The aim of this study was to retrospectively assess the rate of granuloma detection and the impact of thi...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2020-06-01
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| Series: | Gastrointestinal Disorders |
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| Online Access: | https://www.mdpi.com/2624-5647/2/2/17 |
| _version_ | 1827715166657052672 |
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| author | Laura Appleton Euan Watt Fiona Jagger Richard Hansen Richard B. Gearry Andrew S. Day |
| author_facet | Laura Appleton Euan Watt Fiona Jagger Richard Hansen Richard B. Gearry Andrew S. Day |
| author_sort | Laura Appleton |
| collection | DOAJ |
| description | Background: The finding of a mucosal granuloma on histological analysis of endoscopically obtained biopsies in children with Crohn’s disease has been suggested to provide prognostic information. The aim of this study was to retrospectively assess the rate of granuloma detection and the impact of this upon specific disease characteristics and outcomes in children diagnosed with Crohn’s disease. After identification of a group of children previously diagnosed with Crohn’s disease, chart reviews were undertaken to characterise the children as granuloma positive or negative. Disease characteristics at diagnosis (such as disease location and nutritional status) and following diagnosis (such as requirement for immunosuppressive medications and surgical intervention) were noted for each patient. Results: Ninety-four children from two distinct geographical areas were identified. Forty-nine (52.1%) of the children had mucosal granulomata. Children with colonic disease were likely to have granulomata detected (RR = 3.04; <i>p</i> < 0.001). Granulomata were associated with lower weight z-scores at diagnosis (<i>p</i> < 0.05), but not other disease features (e.g., perianal disease or extra-intestinal manifestations). The presence of a granuloma at diagnosis was also associated with increased rates of the subsequent requirement for an immunosuppressive medication (RR = 1.26; <i>p</i> = 0.002). The presence of granulomata on histological assessment of mucosal biopsies at diagnosis of children with Crohn’s disease appears to be associated with specific disease features and outcomes. These findings should be clarified prospectively in a larger cohort of children with Crohn’s disease. |
| first_indexed | 2024-03-10T19:11:40Z |
| format | Article |
| id | doaj.art-fccd6dd049694a2aa0aa14673f9f45bb |
| institution | Directory Open Access Journal |
| issn | 2624-5647 |
| language | English |
| last_indexed | 2024-03-10T19:11:40Z |
| publishDate | 2020-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Gastrointestinal Disorders |
| spelling | doaj.art-fccd6dd049694a2aa0aa14673f9f45bb2023-11-20T03:45:21ZengMDPI AGGastrointestinal Disorders2624-56472020-06-012216417010.3390/gidisord2020017Associations between the Presence of Granulomata and Disease Phenotype and Outcomes in Children Diagnosed with Crohn’s DiseaseLaura Appleton0Euan Watt1Fiona Jagger2Richard Hansen3Richard B. Gearry4Andrew S. Day5Department of Paediatrics, University of Otago Christchurch, Christchurch 8011, New ZealandDepartment of Paediatrics, University of Otago Christchurch, Christchurch 8011, New ZealandSchool of Medicine & Dentistry, University of Aberdeen, Aberdeen AB24 3FX, Scotland, UKDepartment of Paediatric Gastroenterology, Royal Hospital for Children, Glasgow G51 4TF, Scotland, UKDepartment of Medicine, University of Otago Christchurch, Christchurch 8011, New ZealandDepartment of Paediatrics, University of Otago Christchurch, Christchurch 8011, New ZealandBackground: The finding of a mucosal granuloma on histological analysis of endoscopically obtained biopsies in children with Crohn’s disease has been suggested to provide prognostic information. The aim of this study was to retrospectively assess the rate of granuloma detection and the impact of this upon specific disease characteristics and outcomes in children diagnosed with Crohn’s disease. After identification of a group of children previously diagnosed with Crohn’s disease, chart reviews were undertaken to characterise the children as granuloma positive or negative. Disease characteristics at diagnosis (such as disease location and nutritional status) and following diagnosis (such as requirement for immunosuppressive medications and surgical intervention) were noted for each patient. Results: Ninety-four children from two distinct geographical areas were identified. Forty-nine (52.1%) of the children had mucosal granulomata. Children with colonic disease were likely to have granulomata detected (RR = 3.04; <i>p</i> < 0.001). Granulomata were associated with lower weight z-scores at diagnosis (<i>p</i> < 0.05), but not other disease features (e.g., perianal disease or extra-intestinal manifestations). The presence of a granuloma at diagnosis was also associated with increased rates of the subsequent requirement for an immunosuppressive medication (RR = 1.26; <i>p</i> = 0.002). The presence of granulomata on histological assessment of mucosal biopsies at diagnosis of children with Crohn’s disease appears to be associated with specific disease features and outcomes. These findings should be clarified prospectively in a larger cohort of children with Crohn’s disease.https://www.mdpi.com/2624-5647/2/2/17Crohn’s diseasegranulomachildrennutritiondisease outcomes |
| spellingShingle | Laura Appleton Euan Watt Fiona Jagger Richard Hansen Richard B. Gearry Andrew S. Day Associations between the Presence of Granulomata and Disease Phenotype and Outcomes in Children Diagnosed with Crohn’s Disease Gastrointestinal Disorders Crohn’s disease granuloma children nutrition disease outcomes |
| title | Associations between the Presence of Granulomata and Disease Phenotype and Outcomes in Children Diagnosed with Crohn’s Disease |
| title_full | Associations between the Presence of Granulomata and Disease Phenotype and Outcomes in Children Diagnosed with Crohn’s Disease |
| title_fullStr | Associations between the Presence of Granulomata and Disease Phenotype and Outcomes in Children Diagnosed with Crohn’s Disease |
| title_full_unstemmed | Associations between the Presence of Granulomata and Disease Phenotype and Outcomes in Children Diagnosed with Crohn’s Disease |
| title_short | Associations between the Presence of Granulomata and Disease Phenotype and Outcomes in Children Diagnosed with Crohn’s Disease |
| title_sort | associations between the presence of granulomata and disease phenotype and outcomes in children diagnosed with crohn s disease |
| topic | Crohn’s disease granuloma children nutrition disease outcomes |
| url | https://www.mdpi.com/2624-5647/2/2/17 |
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