[Clinical features of Crohn's disease: relationship of disease type and severity to clinical findings at the time of diagnosis in 166 cases].
One hundred and sixty-six Japanese patients with Crohn's disease were subjected to a study of the correlation of disease type and severity to clinical findings including laboratory data, x-ray findings, and complications at the time of diagnosis. Those who had undergone bowel resection and who had localized lesions in the appendix and anorectum, or minimal lesions were not included in this study. According to the site of lesions, the patients were divided into three groups; small intestinal type (n = 81), ileocolic type (n = 61), colonic type (n = 24). In addition, based on the severity of inflammation, the patients were divided into another three groups; those who showed C-reactive protein (CRP) greater than or equal to 4+ and erythrocyte sedimentation rate (ESR) greater than or equal to 40 mm/hour (severe inflammation group, n = 31), those who showed CRP less than or equal to 2+ and ESR less than or equal to 15 mm/hour (mild inflammation group, n = 29), and those who belonged to between the severe and mild inflammation groups (moderate inflammation group, n = 106). The clinical findings at the time of diagnosis were compared between the severe and mild groups to determine the factors contributing to the severity of inflammation, using an univariate analysis and a multivariate one. The results were as follows: 1) Eighty-one patients had isolated small intestinal type of disease (48.8%), 61 ileocolic type (36.7%), and 24 colonic type alone (14.5%). 2) The ratio of male to female was 2.07. The average age at the time of onset was 21.1 years, and the age at diagnosis 23.6 years. 3) The average ages at onset and at the time of diagnosis were younger in patients with ileocolic type than in those with small intestinal or colonic type alone. 4) Patients with colonic type of disease had a higher incidence of bloody stool, diarrhea, and anemia than did those with small intestinal or ileocolic type of disease, while weight loss was most frequently observed in those with ileocolic type. 5) Crohn's disease activity index (CDAI) was the highest in patients with colonic involvement, and those with small intestinal disease had significantly lower values of CDAI than did those with the other disease types. Similarly, both values for CRP and ESR were significantly lower in patients with small intestinal type than in those with the other disease types.(ABSTRACT TRUNCATED AT 400 WORDS)
Tominaga
M
M
Second Department of Internal Medicine, Faculty of Medicine, Kyushu University, Fukuoka.
D000328:Adult; D003424:Crohn Disease / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D012189:Retrospective Studies