MORPHOLOGICAL CRITERIA FOR PREDICTION OF SEVERITY OF CROHN’S DISEASE CLINICAL COURSE IN CHILDREN
https://doi.org/10.15690/vsp.v12i5.808
Abstract
Aim: to establish prognostic morphological criteria of complicated clinical course of Crohn’s disease in children. Patients and methods: morphometric and histological characteristics of the mucous membrane of the large intestine were studied in 27 patients with colitis form of Crohn’s disease on their first admission to a hospital. Results: the most informative predictive morphological criteria for unfavorable prognosis were the following: predominance of the non-active macrophages tending to aggregation in the lamina propria mucosae; destructive vasculitis; increase in the number of fibroblastic cells with the prevalence of the young forms. Non-active macrophages and immature fibroblasts under hypoxia conditions, associated with necrotizing vasculitits, are the factors which contribute to development of fibrosis in the mucous membrane of the large intestine. Conclusitons: unfavorable prognostic morphological criteria of Crohn’s disease were determined. These criteria allow using more aggressive treatment management («top-down» scheme) with early administration of steroid, cytostatic and anti-cytokine drugs in order to prevent the development of complications due to intestinal fibrosis.
About the Authors
E. N. Fedulova
Nizhny Novgorod Scientific Research Institute of Pediatric Gastroenterology
Russian Federation
Fedulova Jel’vira Nikolaevna, MD, Head of the Clinic of Pathology
Russian Federation
Fedulova Jel’vira Nikolaevna, MD, Head of the Clinic of Pathology
E. A. Zhukova
Nizhny Novgorod Scientific Research Institute of Pediatric Gastroenterology
Russian Federation
Russian Federation
O. A. Tutina
Nizhny Novgorod Scientific Research Institute of Pediatric Gastroenterology
Russian Federation
Russian Federation
T. A. Kuznetsova
Nizhny Novgorod Scientific Research Institute of Pediatric Gastroenterology
Russian Federation
Russian Federation
O. V. Shumilova
Nizhny Novgorod Scientific Research Institute of Pediatric Gastroenterology
Russian Federation
Russian Federation
O. V. Fedorova
Nizhny Novgorod Scientific Research Institute of Pediatric Gastroenterology
Russian Federation
Russian Federation
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Review
For citations:
Fedulova E.N., Zhukova E.A., Tutina O.A., Kuznetsova T.A., Shumilova O.V., Fedorova O.V. MORPHOLOGICAL CRITERIA FOR PREDICTION OF SEVERITY OF CROHN’S DISEASE CLINICAL COURSE IN CHILDREN. Current Pediatrics. 2013;12(5):108-111. (In Russ.) https://doi.org/10.15690/vsp.v12i5.808
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