title: Upper gastrointestinal involvement in paediatric onset Crohn's disease: prevalence and clinical implications.
abstract: OBJECTIVE
  Our study evaluated the prevalence, the characteristics and implications of the upper gastrointestinal localisation (UGI+) in paediatric Crohn's Disease (CD) patients.
  
  
  METHODS
  This prospective study evaluated 45 newly diagnosed CD patients at diagnosis and follow up with respect to CD localisation.
  
  
  RESULTS
  All patients presented CD at the colon and/or ileum. In 24/45 patients (53.3%, 12 F and 12 M) an UGI+ involvement was also found. UGI+ patients had a younger age of onset (10.9 years versus 12.6 years; P<0.05). PCDAI at diagnosis was significantly higher in the UGI+ (41 vs. 25 P<0.01). UGI+ patients were overall more symptomatic. Pancolitis and extraintestinal manifestations were also more frequent (19/24 (80%) vs. 12/21 (57%) P<0.01). Growth was more impaired at diagnosis in UGI+ patients. By the end of the follow-up (mean 3 years, range 2 to 4) no significant difference was found in PCDAI (17 in UGI+ patients vs. 11 in UGI- P=NS), or the number of relapses. Weight and growth catch-up in UGI+ patients were comparable to UGI- ones. However, UGI+ patients required a more aggressive therapeutic approach.
  
  
  CONCLUSIONS
  At least half of paediatric onset CD patients have an upper gastrointestinal localisation. UGI+ patients present an earlier onset and a more severe disease. The final outcome does not differ, but UGI+ patients require a more aggressive therapeutic approach.
authors.affiliation: Department of Paediatrics, IRCCS Burlo Garofolo-University of Trieste, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Crocco
authors.forename: S
authors.initials: S
authors.lastname: Martelossi
authors.forename: N
authors.initials: N
authors.lastname: Giurici
authors.forename: V
authors.initials: V
authors.lastname: Villanacci
authors.forename: A
authors.initials: A
authors.lastname: Ventura
mesh_terms: D000293:Adolescent; D017668:Age of Onset; D002648:Child; D003424:Crohn Disease / Q000175:diagnosis / Q000453:epidemiology / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies; D041742:Upper Gastrointestinal Tract / Q000473:pathology*