title: [Frequency and characteristics of granulomas in 368 pediatric patients with Crohn's disease].
abstract: BACKGROUND
  Epitheloid granulomas are one of the best histological criteria for distinguishing Crohn's disease from other inflammatory bowel diseases. However, the role of granuloma in the pathogenesis and clinical characteristics of Crohn's disease is unclear.
  
  
  OBJECTIVE
  The aim of the present study was to evaluate the frequency of granulomas and their association with clinical characteristics using the database of the Hungarian Pediatric Inflammatory Bowel Disease Registry.
  
  
  METHODS
  Three hundred and sixty-eight children with Crohn's disease were registered between January 1st, 2007 and December 31st, 2010.
  
  
  RESULTS
  The frequency of granulomas was 31.4% (111/353) at diagnosis. Isolated granuloma in the upper gastrointestinal tract was detected in 2.5% of patients, while those in the terminal ileum was found in 5% of patients. There was no difference in location, behavior and disease activity indexes between patients with and without granulomas. Need for immunomodulators and biological therapy was similar in the two groups in the first year of diagnosis.
  
  
  CONCLUSIONS
  The frequency of granulomas in this cohort was comparable to the frequency reported in other studies. Interestingly, granulomas in the terminal ileum or upper gastrointestinal tract contributed to the diagnosis of Crohn's disease in one of 13 children. These data indicate that multiple biopsies from multiple sites are essential for the diagnosis of pediatric Crohn's disease.
authors.affiliation: Semmelweis Egyetem, Általános Orvostudományi Kar I. Gyermekgyógyászati Klinika Budapest Bókay u. 53. 1083.
authors.forename: Katalin Eszter
authors.initials: KE
authors.lastname: Müller
authors.forename: Péter László
authors.initials: PL
authors.lastname: Lakatos
authors.forename: Mária
authors.initials: M
authors.lastname: Papp
authors.forename: Gábor
authors.initials: G
authors.lastname: Veres
mesh_terms: D000293:Adolescent; D001706:Biopsy; D002648:Child; D002675:Child, Preschool; D003424:Crohn Disease / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology* / Q000473:pathology / Q000628:therapy; D005260:Female; D006099:Granuloma / Q000175:diagnosis* / Q000453:epidemiology*; D006801:Humans; D006814:Hungary / Q000453:epidemiology; D007082:Ileum / Q000473:pathology; D008297:Male; D012042:Registries; D012189:Retrospective Studies; D041742:Upper Gastrointestinal Tract / Q000473:pathology*
keywords: Crohn-betegség; Crohn’s disease; granuloma; gyermekkori; gyulladásos bélbetegség; pediatric inflammatory bowel disease; registry; regiszter