Chronic Diarrhea as a Debut Manifestation of Crohn’s Disease in Infant: Clinical Case
https://doi.org/10.15690/vsp.v22i1.2518
Abstract
Background. Chronic diarrhea can be a symptom of a wide variety of diseases, either of which requires special therapy approaches. The diagnosis of rare causes of chronic diarrhea is especially difficulty as it may be associated with inflammatory bowel disease (IBD) with very early (under 1 year of age) debut.
Clinical case description. Boy E. had chronic diarrhea manifested on the first year of life. Ulcerative colitis was diagnosed at the age of 1.5 years, then the diagnosis was changed to Crohn’s disease at the age of 2.5 years. The results of 6-years-follow-up of the patient were presented, as well as analysis of diagnosis and treatment difficulties was carried out.
Conclusion. The clinical case of Crohn’s disease with diarrhea as the leading clinical manifestation at the disease onset is described. Sequential diagnostic search allowed us to establish the diagnosis of IBD and to exclude other causes of chronic diarrhea that determined the correct therapeutic strategy.
About the Authors
Anna M. Konovalova
Samara State Medical University
Russian Federation
Disclosure of interest:
Russian Federation
Samara
Disclosure of interest:
Авторы статьи подтвердили отсутствие конфликта интересов, о котором необходимо сообщить.
Dmitry V. Pechkurov
Samara State Medical University
Russian Federation
Disclosure of interest:
Russian Federation
Samara
Disclosure of interest:
Not declared.
Alena A. Tyazheva
Samara State Medical University
Russian Federation
Disclosure of interest:
Russian Federation
Samara
Disclosure of interest:
Not declared.
References
1. WHO. Diarrhoeal disease. World Health Organization. 02 May 2017. (In Russ). https://www.who.int/ru/news-room/factsheets/detail/diarrhoeal-disease.
2. Belmer SV, Gasilina TV. Differential diagnosis and general principles of therapy of chronic diarrhea in children. Farmateka. 2011;(1):54–58. (In Russ).
3. Kornienko EA. Differentsial’nyi diagnoz khronicheskoi diarei u detei. Effektivnaya farmakoterapiya. 2011;(5): 36–43. (In Russ).
4. Novikova VP, Khavkin AI, Prokopyeva NE. IBD-like gastrointestinal disorders in children. Experimental and Clinical Gastroenterology. 2021;(4):161–169. (In Russ). doi: https://doi.org/10.31146/1682-8658-ecg-188-4-161-169
5. Novikova VP. Differential diagnosis of chronic diarrhea in children over 1 year of age. Children’s Medicine of the North-West. 2021;9(2):10–21. (In Russ).
6. Gorelov AV, Zakharova IN, Makarova SG, et al. Review of the expert council materials “Diarrhea differential diagnosis depending on its pathogenesis in pediatric practice, the role of probiotic medications in its treatment”. Clinical Practice in Pediatrics. 2022;17(1):207–212. (In Russ). doi: https://doi.org/10.20953/1817-7646-2022-1-207-212
7. Kabuki T, Ogimi C, Tanaka R, et al. Thalidomide therapy for infantile-onset Crohn’s disease. Nihon Rinsho Meneki Gakkai Kaishi. 2005;28(2):92–98. doi: https://doi.org/10.2177/jsci.28.92
8. Xia L, Wang L, Chung AS, et al. Identification of both positive and negative domains within the epidermal growth factor receptor COOH-terminal region for signal transducer and activator of transcription (STAT) activation. J Biol Chem. 2002;277(34):30716–30723. doi: https://doi.org/10.1074/jbc.M202823200
9. Bolezn’ Krona: Clinical guidelines. Ministry of Health of Russia; 2021. 83 p. (In Russ). Доступно по: http://disuria.ru/_ld/10/1084_kr21K50MZ.pdf. Ссылка активна на 02.02.2023.
10. Uhlig HH. Monogenic diseases associated with intestinal inflammation: implications for the understanding of inflammatory bowel disease. Gut. 2013;62(12):1795–1805. doi: https://doi.org/10.1136/gutjnl-2012-303956
11. Dinulos JG, Darmstadt GL, Len MK, et al. Infantile Crohn disease presenting with diarrhea and pyoderma gangrenosum. Pediatr Dermatol. 2006;23(1):43–48. doi: https://doi.org/10.1111/j.1525-1470.2006.00169.x
12. Bekin AS, D’yakonova EYu, Surkov AN, et al. Maski vospalitel’nykh zabolevanii kishechnika v khirurgicheskoi praktike. Russian Journal of Pediatric Surgery = Detskaya Khirurgiya. 2019;23(1S1):18. (In Russ).
13. Kim TH, Bae SC, Lee SH, et al. Association of complement receptor 2 gene polymorphism with predisposition to osteonecrosis of the femoral head in systemic lupus erythematosus. Biomed Res Int. 2016;2016:9208035. doi: https://doi.org/10.1155/2016/9208035
14. Shchigoleva AE, Shumilov PV, Shumilov АР. Inflammatory bowel diseases with very early onset. Pediatria. Journal n.a. G.N. Speransky. 2018;97(6):141–146. (In Russ). doi: https://doi.org/10.24110/0031-403X-2018-97-6-141-146
15. Sandborn WJ, Feagan BG, Rutgeerts P, et al. Vedolizumab as induction and maintenance therapy for Crohn’s disease. N Engl J Med. 2013;369(8):711–721. doi: https://doi.org/10.1056/NEJMoa1215739
16. Singh N, Rabizadeh S, Jossen J, et al. Multi-center experience of Vedolizumab effectiveness in pediatric inflammatory bowel disease. Inflamm Bowel Dis. 2016;22(9):2121–2126. doi: https://doi.org/10.1097/MIB.0000000000000865
17. Ledder O, Assa A, Levine A, et al. Vedolizumab in pediatric inflammatory bowel disease: a retrospective multi-center experience from the Paediatric IBD Porto group of ESPGHAN. J Crohns Colitis. 2017; 11(10):1230–1237. doi: https://doi.org/10.1093/ecco-jcc/jjx082
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For citations:
Konovalova A.M., Pechkurov D.V., Tyazheva A.A. Chronic Diarrhea as a Debut Manifestation of Crohn’s Disease in Infant: Clinical Case. Current Pediatrics. 2023;22(1):68-72. (In Russ.) https://doi.org/10.15690/vsp.v22i1.2518
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