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001-es BibID:BIBFORM043060
Első szerző:Muller, K.
Cím:A nation-wide registry of paediatric inflammatory bowel disease : improvement of diagnostic workup and Paris Classification / K. Muller, Hungarian Pediatric IBD, M. Papp, P. Lakatos, G. Veres
Megjegyzések:Background: A nationwide registry may serve as a mirrorreflecting the quality of health care. It is a method for detectingfailure in diagnostic workup or in management practice. We evaluated whether diagnostic workup of paediatricinflammatory bowel disease (IBD) patients fulfils Porto Criteria. Furthermore, we analyzed whether the diagnostic practice haschanged since the Hungarian Paediatric IBD Registry exists.In addition, there has been no large paediatric IBD cohortanalyzed according to Paris classification.Methods: Newly diagnosed paediatric patients with IBD(0 18 years) are registered in this prospective registry. All the twentyseven paediatric institutes with paediatricgastroenterology serve data ensuring a nationwide approach.The questionnaire includes epidemiological data, diseaseextension, disease activity (PCDAI, PUCAI) and initial therapy. Results: Between 2007 and 2011, 712 new IBD cases wereidentified (449 Crohn's disease (CD), 217 ulcerative colitis (UC)and 46 IBD-unclassified). Upper endoscopy was performed in 52.6% of the patients in 2007, and this rate has increased to78.2% by 2011. Proportion of ileoscopy has changed from 53% to 69%. Imaging of the small bowel did not change during the years(range: 31.2 42%), but the modality of imaging has altered. MRIwas performed in 7.5% of patients in 2007 and in 24.8% in 2011.Localization (Paris classification) could be evaluated in 512patients. 84/173 UC patients had E4 classification, 32 childrenhad E3 localization and 10 cases presented with proctitis. S1severity was found in 15 patients (11.5%) at diagnosis. In CD 219 (64%) children had upper gastrointestinal involvement,72.6% patients had L4a, 12.3% had L4b, and 15.1% hadL4ab classification. Six patients (1.4%) belonged to B2B3, 10children (2.3%) had B3 and 46 (10.4%) CD patients had B2phenotype. Localization differed in age groups: involvementof the terminal ileum was significantly lower in A1a age groupthan in A1b (U=6216, p < 0.001) or A2 groups (U=768, p = 0.022).Perianal disease was significantly higher in patients with L4bthan in L4a (25.9% vs. 9.4% p = 0.023). PCDAI was significantlyhigher in patients with L3 than in patients with L1 or L2disease extension (35.9 vs. 28.2 (p = 0.001) and 35.9 vs. 27.2p < 0.001). Conclusions: The quality of diagnostic workup in paediatricpatients with IBD improved in the last 5 years. Parisclassification of the IBD patients seems to be a more preciseclassification, providing distinct subgroups for further analysis.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idézhető absztrakt
Megjelenés:Journal of Crohn's and Colitis. - 7 : S1 (2013), p. S276-S277. -
További szerzők:Papp Mária (1975-) (belgyógyász, gasztroenterológus) Lakatos Péter (belgyógyász) Veres Gábor (orvos) Hungarian Pediatric IBD
Internet cím:Intézményi repozitóriumban (DEA) tárolt változat
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