title: Diagnostic yield of upper endoscopy in paediatric patients with Crohn's disease and ulcerative colitis. Subanalysis of the HUPIR registry.
abstract: OBJECTIVE
  According to Porto Criteria upper gastrointestinal (UGI) endoscopy is recommended in patients with suspected inflammatory bowel disease (IBD). Nevertheless, previous studies revealed frequent involvement of UGI tract even in patients with ulcerative colitis (UC). The aim of the present study was to determine the diagnostic role of esophagogastroduodenoscopy (EGD) and assess the prevalence and different aspects of UGI involvement in children registered in the Hungarian Pediatric IBD Registry (HUPIR) from 1st of January 2007 to 31th of December 2009.
  
  
  METHODS
  Twenty seven institutes provided prospective follow-up data about newly diagnosed IBD patients to HUPIR. The registry was based on detailed questionnaire (76 parameters) involving anamnestic data, laboratory findings, activity indexes, diagnostic procedures, endoscopic examinations (EGD and ileocolonoscopy), and histological data. Localization and phenotype of disease were based on the Montreal classification criteria.
  
  
  RESULTS
  During the 3-year period 420 children were diagnosed with IBD, 265 (63%) of them had Crohn's disease (CD), 130 (31%) UC, and 25 (6%) IBD-unclassified (IBD-U). The mean age at diagnosis was 13.2 years (range: 1.2-18 years). EGD was performed in 237 patients (56%), in most cases in patients suffering from CD. Macroscopic lesions on EGD were noted in 64% of patients with CD and 40% of children with UC. Characteristic lesions for CD (ulcer, erosion, aphthous lesion, and granuloma) were noted in 31% of CD patients, however, EGD helped to establish the final diagnosis in 9% of CD patients (diagnostic yield, 9%).
  
  
  CONCLUSIONS
  There was a high frequency of UGI involvement in children with CD and UC. One third of CD patients showed significant lesions at upper endoscopy and one patient out of ten had real diagnostic help from EGD.
authors.affiliation: Petz Aladár County Teaching Hosp., Győr, Hungary.
authors.forename: Marta
authors.initials: M
authors.lastname: Kovacs
authors.forename: Katalin Eszter
authors.initials: KE
authors.lastname: Muller
authors.forename: Andras
authors.initials: A
authors.lastname: Arato
authors.forename: Peter Laszlo
authors.initials: PL
authors.lastname: Lakatos
authors.forename: Judit B
authors.initials: JB
authors.lastname: Kovacs
authors.forename: Agnes
authors.initials: A
authors.lastname: Varkonyi
authors.forename: Eniko
authors.initials: E
authors.lastname: Solyom
authors.forename: Marianne
authors.initials: M
authors.lastname: Polgar
authors.forename: Eva
authors.initials: E
authors.lastname: Nemes
authors.forename: Ildiko
authors.initials: I
authors.lastname: Guthy
authors.forename: Istvan
authors.initials: I
authors.lastname: Tokodi
authors.forename: Gergely
authors.initials: G
authors.lastname: Toth
authors.forename: Agnes
authors.initials: A
authors.lastname: Horvath
authors.forename: Andras
authors.initials: A
authors.lastname: Tarnok
authors.forename: Erika
authors.initials: E
authors.lastname: Tomsits
authors.forename: Noemi
authors.initials: N
authors.lastname: Csoszánszky
authors.forename: Marta
authors.initials: M
authors.lastname: Balogh
authors.forename: Noemi
authors.initials: N
authors.lastname: Vass
authors.forename: Piroska
authors.initials: P
authors.lastname: Bodi
authors.forename: Antal
authors.initials: A
authors.lastname: Dezsofi
authors.forename: Laszlo
authors.initials: L
authors.lastname: Gardos
authors.forename: Eva
authors.initials: E
authors.lastname: Micskey
authors.forename: Maria
authors.initials: M
authors.lastname: Papp
authors.forename: Daniel
authors.initials: D
authors.lastname: Szucs
authors.forename: Aron
authors.initials: A
authors.lastname: Cseh
authors.forename: Kriszta
authors.initials: K
authors.lastname: Molnar
authors.forename: Doloresz
authors.initials: D
authors.lastname: Szabo
authors.forename: Gabor
authors.initials: G
authors.lastname: Veres
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003093:Colitis, Ulcerative / Q000175:diagnosis* / Q000473:pathology; D003424:Crohn Disease / Q000175:diagnosis* / Q000473:pathology; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D012042:Registries; D011795:Surveys and Questionnaires