Presenting symptoms and diagnostic lag in children with inflammatory bowel disease
Presenting symptoms and diagnostic lag in children with inflammatory bowel disease
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DOI：
10.1097/00054725-199908000-00002
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发表时间：
1999-08-01
影响因子：
4.9
通讯作者：
Balint, JP
中科院分区：
文献类型：
--
作者：
Heikenen, JB;Werlin, SL;Balint, JP
呈现症状及其持续时间可能会影响炎症性肠病（IBD）确诊前的时间。本研究旨在确定IBD儿童出现症状的平均持续时间和诊断滞后。回顾了1990-1995年间在威斯康星州儿童医院儿科胃肠病门诊诊断为LED的所有19岁以下患者的病历。分析了诊断时的年龄、性别、症状和持续时间、疾病部位和诊断滞后。有91名儿童（49名男性）被诊断患有IBD。克罗恩病（CD）被诊断为58例，溃疡性结肠炎（UC）24例，未确定结肠炎9例。CD的平均诊断年龄为11.4岁，UC为9.7岁，不确定性结肠炎为7.8岁。最常见的症状是腹痛、腹泻、便血和体重减轻。CD诊断的平均延迟时间为7.1个月，根据疾病部位不同而不同：小肠10.5个月，回结肠7.5个月，结肠6.4个月。UC的诊断平均滞后时间为6.7个月，不确定性结肠炎为14个月。表现为生长障碍的儿童的诊断滞后时间最长。(a)症状发作和CD诊断之间的时间缩短。(b)CD的诊断延迟随着远端结肠受累而减少。(c)症状发作后，UC的诊断仅略快于CD。
Presenting symptoms and their duration may affect the time that elapses prior to definitive diagnosis of inflammatory bowel disease (IBD). This study was undertaken to determine the mean duration of presenting symptoms and diagnostic lag in children with IBD. The medical records of all patients less than 19 years of age diagnosed with LED at the pediatric gastroenterology clinic of Children's Hospital of Wisconsin between 1990-1995 were reviewed. The age at diagnosis, gender, presenting symptoms and duration, disease location, and diagnostic lag were analyzed. There were 91 children (49 male) diagnosed with IBD. Crohn's disease (CD) was diagnosed in 58, ulcerative colitis (UC) in 24, and indeterminate colitis in 9. The mean ages at diagnosis were 11.4 years for CD, 9.7 years for UC, and 7.8 years for indeterminate colitis. The most frequent presenting symptoms were abdominal pain, diarrhea, hematochezia, and weight loss. The average lag in diagnosis of CD was 7.1 months, which varied by disease location: small intestine 10.5 months, ileocolonic 7.5 months, and colonic 6.4 months. The average lag in diagnosis was 6.7 months for UC and 14 months for indeterminate colitis. Children presenting with growth failure had the longest diagnostic lag. (a) The elapsed time between symptom onset and the diagnosis of CD has decreased. (b) The diagnostic lag in CD decreases with distal colonic involvement. (c) Following onset of symptoms UC was diagnosed only slightly more rapidly than CD.