Diagnostic yield of upper endoscopy in paediatric patients with Crohn's disease and ulcerative colitis. Subanalysis of the HUPIR registry

Marta Kovacs, Katalin Eszter Muller, Andras Arato, Peter Laszlo Lakatos, Judit B. Kovacs, Agnes Varkonyi, Eniko Solyom, Marianne Polgar, Eva Nemes, Ildiko Guthy, Istvan Tokodi, Gergely Toth, Agnes Horvath, Andras Tarnok, Erika Tomsits, Noemi Csoszánszky, Marta Balogh, Noemi Vass, Piroska Bodi, Antal DezsofiLaszlo Gardos, Eva Micskey, Maria Papp, Daniel Szucs, Aron Cseh, Kriszta Molnar, Doloresz Szabo, Gabor Veres

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Background, aims: According to Porto Criteria upper gastrointestinal (UGI) endoscopy is recommended in patients with suspected inflammatory bowel disease (IBD). Nevertheless, previous studies revealed frequent involvement of UGI tract even in patients with ulcerative colitis (UC). The aim of the present study was to determine the diagnostic role of esophagogastroduodenoscopy (EGD) and assess the prevalence and different aspects of UGI involvement in children registered in the Hungarian Pediatric IBD Registry (HUPIR) from 1st of January 2007 to 31th of December 2009. Methods: Twenty seven institutes provided prospective follow-up data about newly diagnosed IBD patients to HUPIR. The registry was based on detailed questionnaire (76 parameters) involving anamnestic data, laboratory findings, activity indexes, diagnostic procedures, endoscopic examinations (EGD and ileocolonoscopy), and histological data. Localization and phenotype of disease were based on the Montreal classification criteria. Results: During the 3-year period 420 children were diagnosed with IBD, 265 (63%) of them had Crohn's disease (CD), 130 (31%) UC, and 25 (6%) IBD-unclassified (IBD-U). The mean age at diagnosis was 13.2 years (range: 1.2-18 years). EGD was performed in 237 patients (56%), in most cases in patients suffering from CD. Macroscopic lesions on EGD were noted in 64% of patients with CD and 40% of children with UC. Characteristic lesions for CD (ulcer, erosion, aphthous lesion, and granuloma) were noted in 31% of CD patients, however, EGD helped to establish the final diagnosis in 9% of CD patients (diagnostic yield, 9%). Conclusions: There was a high frequency of UGI involvement in children with CD and UC. One third of CD patients showed significant lesions at upper endoscopy and one patient out of ten had real diagnostic help from EGD.

Original languageEnglish
Pages (from-to)86-94
Number of pages9
JournalJournal of Crohn's and Colitis
Volume6
Issue number1
DOIs
Publication statusPublished - Feb 1 2012

    Fingerprint

Keywords

  • Crohn disease
  • Diagnostic yield
  • Esophagogastroduodenoscopy
  • Paediatric
  • Ulcerative colitis
  • Upper gastrointestinal tract

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Kovacs, M., Muller, K. E., Arato, A., Lakatos, P. L., Kovacs, J. B., Varkonyi, A., Solyom, E., Polgar, M., Nemes, E., Guthy, I., Tokodi, I., Toth, G., Horvath, A., Tarnok, A., Tomsits, E., Csoszánszky, N., Balogh, M., Vass, N., Bodi, P., ... Veres, G. (2012). Diagnostic yield of upper endoscopy in paediatric patients with Crohn's disease and ulcerative colitis. Subanalysis of the HUPIR registry. Journal of Crohn's and Colitis, 6(1), 86-94. https://doi.org/10.1016/j.crohns.2011.07.008