Medicine of the Future in America

Long-term prognosis of early-onset Crohn’s disease: DISCUSSION (Part 1)

intestinal resectionThe present study focused on an exploration of specific disease end points traditionally used as clinical indicators of long-term prognosis in Crohn’s disease, but applied to early-onset disease diagnosed during childhood or adolescence. These included malignancy and mortality as well as the requirement for intestinal resection. As anticipated, the results show that both early malignancy and mortality are rare, each being noted only in single patients (eg, rectal cancer, suicidal drug overdose), around 40 years of age and beyond. These observations are consistent with the results in other studies on clinical features of pediatric Crohn’s disease that have failed to record superimposed or complicating intestinal malignancies. Indeed, colorectal cancer complicating early-onset Crohn’s disease has been rarely reported, and has been considered to be more likely related to another occult or underlying genetically-based disorder (eg, Li-Fraumeni syndrome) than Crohn’s disease per se. Please make sure you read all the information provided above to choose the right medications at the to benefit the most from the treatment. At this pharmacy, you will find tons of cheap and efficient meds for any problem.

While not systematically examined in the present study, regular colonoscopic screening programs for epithelial dysplasia (or invasive neoplasia) appear not to be indicated in children or adolescents with Crohn’s disease. Not a single patient in this cohort of 224 patients followed for a prolonged period by a single clinician had epithelial dysplasia recorded in endoscopic biopsies or surgically resected specimens, including the sole patient who eventually developed colorectal cancer.

This entry was posted in Crohn’s disease and tagged Clinical behaviour of Crohn’s disease, Crohn's disease, Granulomatous colitis, Natural history of Crohn’s disease, Vienna classification.
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