[Diffuse jejuno-ileitis of Crohn's disease: a separate form of the disease?].
OBJECTIVE
Diffuse jejuno-ileitis of Crohn's disease may be a homogeneous clinical subgroup. The aim of this work was to compare the demographic and clinical data at diagnosis and the initial treatments of patients with diffuse jejuno-ileitis of Crohn's disease and to the ones without this localization.


METHODS
For demographic and clinical studies, 48 (32M/16F) incident cases of diffuse jejuno-ileitis of Crohn's disease diagnosed between 1988 and 1994 in the EPIMAD register were compared with 96 (48M/48F) controls diagnosed the same year. As far as for the therapeutic management, the 48 incident cases were compared with 48 controls.


RESULTS
Diffuse jejuno-ileitis constituted 3.3% of the total incident cases. Median age at diagnosis was significantly lower (20 vs 23 years, P = 0.01) and an upper digestive involvement was more frequent (56% vs 34%, P = 0.03) in patients with diffuse jejuno-ileitis. These patients were more often treated by total parenteral nutrition (43.8% vs 19.6%, P = 0.01) or azathioprine (50% vs 20.8%, P = 0.005). Azathioprine was also introduced earlier (20.7 vs 40.3 months, P = 0.009). Surgery for resection was less often required in diffuse jejuno-ileitis than in controls (65.2% vs 99.8%, P = 0.02) while more stricturoplasties were performed (52.9% vs 10%, P = 0.003); overall surgical rates did not significantly differ in the 2 groups.


CONCLUSIONS
Our series suggest that diffuse jejuno-ileitis of Crohn's disease is a subgroup of patients characterized by a young age at diagnosis, with more frequent and earlier requirement for azathioprine.
Touze
I
I
Service de Chirurgie Adultes Ouest, Hôpital Huriez, CHU, Lille.
Gower-Rousseau
C
C
Grandbastien
B
B
Paris
J C
JC
Quandalle
P
P
Cortot
A
A
Colombel
J F
JF
D000293:Adolescent; D000328:Adult; D000375:Aging; D001379:Azathioprine / Q000627:therapeutic use; D003424:Crohn Disease / Q000473:pathology / Q000628:therapy*; D004751:Enteritis / Q000473:pathology / Q000628:therapy*; D005260:Female; D006801:Humans; D007077:Ileal Diseases / Q000473:pathology / Q000628:therapy*; D007579:Jejunal Diseases / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010289:Parenteral Nutrition, Total
D001379:Azathioprine
Maladie de Crohn jéjuno-iléale diffuse: une forme particulière de la maladie?