title: [Severe Crohn's disease in children. Retrospective study of 38 cases].
abstract: Thirty-eight children presenting with severe Crohn's disease (CD) were studied retrospectively over a mean period of 6 years. The severity of CD was estimated according to an activity score. This was initially 66 +/- 19 reaching 100 in 16% of cases. Initial involvement included ileon and large intestine only (n = 23), large intestine (n = 11) and ileon only (n = 4), with upper GI tract or perineal involvement in 32 and 75% of cases respectively. The treatments consisted of corticosteroids (n = 34), azathioprine (n = 11), continuous enteral feeding (CEF) (n = 25), parenteral nutrition (PN) (n = 30). Mean recurrence rates per patient and per year were 0.6 in the groups including ileon and large intestine or the large intestine only and 0.3 in the ileal group. A surgical resection was performed in 20 cases with a mean rate of reoperation of 40% at 5 years. Reoperations were necessary only in the group involving the ileon and large intestine. Mean weight catch-up in 3 months and height growth speed were 6 kg and 1.7 to 3.1 cm/year under CED and/or PN. After a 6 year follow-up the activity index was decreased by 70% with a quality of life considered to be good in 60% of cases.
authors.affiliation: Service de Gastroentérologie et Nutrition, Hôpital Necker-Enfants-Malades, Paris.
authors.forename: E
authors.initials: E
authors.lastname: Sadoun
authors.forename: O
authors.initials: O
authors.lastname: Goulet
authors.forename: J F
authors.initials: JF
authors.lastname: Mougenot
authors.forename: V
authors.initials: V
authors.lastname: Colomb
authors.forename: S
authors.initials: S
authors.lastname: De Potter
authors.forename: J
authors.initials: J
authors.lastname: Schmitz
authors.forename: C
authors.initials: C
authors.lastname: Nihoul-Fékété
authors.forename: N
authors.initials: N
authors.lastname: Brousse
authors.forename: C
authors.initials: C
authors.lastname: Ricour
mesh_terms: D002648:Child; D003424:Crohn Disease / Q000503:physiopathology* / Q000601:surgery / Q000628:therapy; D004750:Enteral Nutrition; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010288:Parenteral Nutrition; D012008:Recurrence; D012189:Retrospective Studies; D013997:Time Factors
vernacular_title: Maladie de Crohn sévère de l'enfant. Etude rétrospective de 38 cas.