Modern principles of Crohn's disease diagnosis in children

• Main Authors: D. S. Soleiko, O.M. Horbatiuk, N. P. Soleiko, V. V. Soleiko
• Format: Article
• Language: English
• Published: Zaporozhye State Medical University 2020-06-01
• Series: Zaporožskij Medicinskij Žurnal
• Subjects: crohn’s disease; children; diagnosis
• Online Access: http://zmj.zsmu.edu.ua/article/view/204957/206001

The aim of our work is to review and analyze scientific literature to highlight the world experience in diagnosing Crohn’s disease (CD) in children, given the need to maintain a unified strategy in diagnostic tactics for this pathology. CD is an autoimmune disease with a chronic progressive transmural inflammatory process of unknown etiology, which can affect the entire gastrointestinal tract from the oral cavity to the anal canal in patients of any age. Approximately 20–25 % of CD cases manifest in patients under the age of 18 years. The pathogenesis of CD is a multifocal process in which genetic mutations of more than 50 genes take place. Morphological changes are diverse and not fully understood. CD is characterized by systemic, local manifestations and the presence of surgical complications. The main diagnostic methods are endoscopic, radiological, morphological and MRI. Differential diagnosis of CD should include ulcerative colitis, inflammatory and autoimmune intestinal diseases in children, congenital malformations of the gastrointestinal tract. Today, the diagnosis of CD in children remains debatable. Conclusions. In the lack of a clear idea of the etiological factors, pathogenesis of CD in children and its consequences, finding diagnostic tactics for this pathology determines the urgency of the issue in pediatrics and pediatric surgery. Diagnostic search in children with CD is a lengthy and materially expensive, requiring powerful facilities and equipment as well as fundamental competencies of a physician. The cascade approach to the diagnosis of CD proposed by the World Gastroenterology Organization (WGO) is the best option for determining the optimal targeted diagnostic algorithm for each patient, taking into account the existing logistic support at a hospital and the financial capacity of a patient.