Baseline Wall Thickness Is Lower in Mucosa-Healed Segments 1 Year After Infliximab in Pediatric Crohn Disease Patients.
J Pediatr Gastroenterol Nutr
; 64(2): 279-285, 2017 02.
Article
em En
| MEDLINE
| ID: mdl-27050057
ABSTRACT
OBJECTIVES:
We aimed to quantitatively investigate the therapeutic response to combined immunosuppression treatment by magnetic resonance enterography (MRE) in active luminal Crohn disease (CD) in the pediatric population.METHODS:
Pediatric patients with moderate-to-severe luminal CD, who received scheduled infliximab and azathioprine, were included in this preliminary study. Ileocolonoscopy and MRE were performed at baseline and at 1 year, and Simple Endoscopic Score for Crohn's Disease (SES-CD) and Magnetic Resonance Index of Activity (MaRIA) scores were calculated. The correlation between SES-CD and MaRIA scores were investigated with analysis per person and per segment.RESULTS:
A total of 167 segments from 17 patients were evaluated by both Ileocolonoscopy and MRE. SES-CD and MaRIA scores showed significant correlations on both per-person analysis (ρâ=â0.699, Pâ<â0.001) and per-segment analysis (ρâ=â0.596, Pâ<â0.001). Analysis according to ileocolonic location of each segment revealed that the correlation strength was strongest in the right colon (ρâ=â0.653, Pâ<â0.001), whereas the correlation in the rectum was statistically insignificant (ρâ=â0.29, Pâ=â0.096). A comparative analysis of MaRIA components revealed a significantly thinner bowel wall thickness at baseline in endoscopically healed segments (50/65) compared with unhealed segments (15/65) (median 4.3 vs 7.2 mm, Pâ=â0.036).CONCLUSIONS:
Therapeutic response to combined immunosuppression at 1 year assessed by MRE correlates with ileocolonoscopy in pediatric patients with CD. Bowel wall thickness of the involved segments at baseline may affect treatment response to combined immunosuppression.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Azatioprina
/
Doença de Crohn
/
Colo
/
Infliximab
/
Íleo
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Imunossupressores
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Mucosa Intestinal
Tipo de estudo:
Diagnostic_studies
/
Observational_studies
/
Prognostic_studies
Limite:
Adolescent
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Child
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Female
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Humans
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Male
Idioma:
En
Revista:
J Pediatr Gastroenterol Nutr
Ano de publicação:
2017
Tipo de documento:
Article