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[To grow up with Crohn's disease].

OBJECTIVE
To assess the characteristics and course of childhood-onset Crohn's disease among Hungarian patients.


METHODS
Records of 81 patients admitted between 1984 and 2006 and treated at least for one year until the 18th year of age were reviewed.


RESULTS
There was a 62% male dominance and a rate of 12.5% of familial cases. The diagnostic lag was 11.36 (1-96) months. The mean age was 13.6 years (4-17), the activity index was 37.88 (5-80) at diagnosis and the initial frequencies were as follows: ileal affection 87%, stricturing and penetrating forms 27%, perianal manifestation 26%, giant cells or granuloma formation 47%, malnutrition 23,5%, growth failure 11%. Steroid therapy and azathioprin treatment were given in 84% and 62% of the patients, respectively. Biologic treatment was not possible during the study period. 31% of the patients underwent surgery (abdominal surgery 20%, perianal surgery 11%). When patients reached the 18th year of age the mean activity index decreased to 6.63 (0-35), the rate of malnutrition to 9.9% and that of growth failure to 2.5%. All these changes were statistically significant.


CONCLUSIONS
Characteristics of childhood-onset Crohn's disease in Hungary are similar to those obtained in other European countries. The prolonged diagnostic lag, the high initial activity index, the granuloma formation and the stricturing/penetrating behavior may predict subsequent complications and need for surgery, and, therefore, justify intense initial therapy. The early introduction of immunomodulatory therapy affects favorably the course of illness.