Diarrhea as a mask of Crohn’s disease

Introduction. Crohn’s disease (CD) is a chronic, recurrent disease characterized by inflammation of the large and/or small intestine or the entire gastrointestinal tract with the formation of local and systemic complications. Diarrhea can act as a mask of CD, which increases the time for diagnosis and timely administration of therapy. The aim of our work is to determine the diagnostic significance of diarrhea as a marker of CD in children.

Materials and methods. Eighty six patients aged of 3 to 17 years and 6 months with a verified diagnosis of CD who were in the Gastroenterological department and the surgical department with routine care from 2018 to 2024 were examined. The analysis of clinical symptoms, activity. and endoscopic picture of CD in children was carried out. The assessment of CD activity in children was carried out according to the PCDAI scale.

Results. 65% of CD patients showed symptoms of intestinal infection: fever, abdominal pain, and diarrhea syndrome, vomiting, weight loss. Fever was observed in 23.3%, abdominal pain syndrome in 69.7%, and diarrhea syndrome in 50% of patients. At the same time, clostridial infection was detected in only 17% of patients. Lesions of the small and large intestine were detected in 65%, lesions of the colon in 22%, lesions of the small intestine in 9%, total lesions of all parts of the gastrointestinal tract in 4% of cases. Characteristic changes in CD children were hypoalbuminemia, anemia, and a significant increase in fecal calprotectin levels.

Conclusion. CD children require a special approach when conducting a systemic diagnostic search due to the high frequency of nonspecific and extra-intestinal manifestations.

Contribution:
Dyakonova E.Yu., Usoltseva O.V. — concept and design of the study;
Dyakonova E.Yu., Bekin A.S., Gusev A.A., Usoltseva O.V. — collection and processing of the material;
Bekin A.S., Gusev A.A., Usoltseva O.V. — writing the text;
Dyakonova E.Yu., Usoltseva O.V. — editing the text.
All co-authors — approval of the final version of the article, responsibility for the integrity of all parts of the article.

Acknowledgment. The study had no sponsorship.

Conflict of interest. The authors declare no conflict of interest.

Received: February 05, 2025
Accepted: March 18, 2025
Published: April 29, 2025

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