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KMID : 0311120220630070675
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Yonsei Medical Journal
2022 Volume.63 No. 7 p.675 ~ p.682
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Initial Abdominal CT and Laboratory Findings Prior to Diagnosis of Crohn’s Disease in Children
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Kang Cho-Eum
Yoon Hae-Sung
Park So-Won
Kim Ji-Soo
Han Kyung-Hwa
Kim Seung
Koh Hong
Lee Mi-Jung
Shin Hyun-Joo
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Abstract
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Purpose: To identify initial abdominal computed tomography (CT) and laboratory findings prior to a diagnosis of Crohn’s disease(CD) in children.
Materials and Methods: In this retrospective study, patients (≤18 year-old) who were diagnosed with CD from 2004 to 2019 andhad abdominal CT just prior to being diagnosed with CD were included in the CD group. Patients (≤18 years old) who were diag nosed with infectious enterocolitis from 2018 to 2019 and had undergone CT prior to being diagnosed with enterocolitis were in cluded as a control group. We assessed the diagnostic performances of initial CT and laboratory findings for the diagnosis of CDusing logistic regression and the area under the curve (AUC).
Results: In total, 107 patients (50 CD patients, 57 control patients) were included, without an age difference between groups (me dian 13 years old vs. 11 years old, p=0.119). On univariate logistic regression analysis, multisegmental bowel involvement, mesen teric vessel engorgement, higher portal vein/aorta diameter ratio, longer liver longitudinal diameter, lower hemoglobin (≤12.5 g/dL), lower albumin (≤4 g/dL), and higher platelet (>320×103/μL) levels were significant factors for CD. On multivariate analysis,multisegmental bowel involvement [odds ratio (OR) 111.6, 95% confidence interval (CI) 4.778?2605.925] and lower albumin levels(OR 0.9, 95% CI 0.891?0.993) were significant factors. When these two features were combined, the AUC value was 0.985 with asensitivity of 96% and specificity of 100% for differentiating CD.
Conclusion: Multisegmental bowel involvement on CT and decreased albumin levels can help differentiate CD from infectiousenterocolitis in children prior to a definite diagnosis of CD.
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KEYWORD
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Crohn disease, child, adolescent, early diagnosisl tomography, X-ray computed
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