Diagnosis and management of Crohn’s disease in retarded child

• Main Author: Rahmi Amtha
• Format: Article
• Language: English
• Published: Universitas Airlangga 2009-06-01
• Series: Dental Journal: Majalah Kedokteran Gigi
• Subjects: Crohn’s disease; diagnosis; management; child
• Online Access: http://e-journal.unair.ac.id/index.php/MKG/article/view/957
• ISSN: 1978-3728; 2442-9740

<span style="font-family: TribuneBold; font-size: 10pt; color: #231f20; font-style: normal; font-variant: normal;"><strong>Background: </strong><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>Crohn’s disease is an uncommon condition characterized by granulomatous lesions. It is a rare disease and affects </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>mainly in the terminal ileum. It may also manifest in the oral cavity as an unhealed, painful chronic apthous-like ulcer and may be </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>undiganosed, so that it leads to the mismanagement of the disease. </em><span style="font-family: TribuneBold; font-size: 10pt; color: #231f20; font-style: normal; font-variant: normal;"><strong>Purpose: </strong><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>To overview the establisment and managment of a retarded </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>child with chronic painfull ulcers and gastrointestinal problems. </em><span style="font-family: TribuneBold; font-size: 10pt; color: #231f20; font-style: normal; font-variant: normal;"><strong>Case: </strong><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>An 11-year-old retarded child who complained of ulcers since </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>6 months ago on the both side of the cheek and the lateral border of the tongue. Large irregular lesions were found accompanied by </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>lips swelling, gingival hyperplasia, mucosal tags, hypersalivation. The blood test showed that the patient was suffering from anemia </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>and haematinic (Fe, Folat and vitamin B12) deficiencies. Weight loss occurred for last 6 months, abdominal pain and constipation </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>were also identified. Daily food pattern showed imbalance food intake. Histopathology features showed granolumatous lesions and was </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>confirmed as a Crohn’s disease. </em><span style="font-family: TribuneBold; font-size: 10pt; color: #231f20; font-style: normal; font-variant: normal;"><strong>Case management: </strong><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>Reassurance and team work with gastroenterologist were performed. Systemic </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>sulfasalazin combined with corticosteroid and multivitamin were administered. Oral hygiene was maintained with hyaluronic acid </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>mouthwash. Reduced in size of ulcer, pain and swelling were shown gradually. Oral ulcers and gastrointestinal symptoms disappeared </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>after 2 months treatment. </em><span style="font-family: TribuneBold; font-size: 10pt; color: #231f20; font-style: normal; font-variant: normal;"><strong>Conclusion: </strong><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>Diagnosis of Crohn’s disease needs a comprehensive clinical examination and histopathological </em><span style="font-family: TribuneItalic; font-size: 9pt; color: #231f20; font-style: normal; font-variant: normal;"><em>test are mandatory to be able to manage the disease thoroughly.</em></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span>