CLINICAL FEATURES IN CROHN'S DISEASE - A RETROSPECTIV BICENTRYC STUDY (BUCHAREST, TIMISOARA) DURING 2005-2009
Abstract:
The aim of our study is the characterization of Crohn's disease (CD) in terms of clinical onset,
the degree of activity, the appearance and the topographical distribution of the lesions and the clinical and
the pathological behavior of the disease. Materials and Methods The study group consists of adults (> 18
years) with newly diagnosed CD investigated in The Fundeni Institute, The Center of Gastroenterology and
Hepatology and in the Department of Gastroenterology and Hepatology, of The Emergency County
Hospital Timisoara during the period 2005-2009. Results The major signs and symptoms at admission
were: chronic diarrhea in 59.4% of the cases, abdominal pain in 45%, weight loss (below 10% of the ideal
weight) in 39.4% of the cases. By correspondingly Harvey-Bradshaw index, 27.2% of the cases were
classified as having mild activity, 43.3% of the cases as moderate activity, 3.9% engaged in severe activity;
25.6% of the patients were classified as inactive clinicaly and biologicaly. Typical findings on endoscopy
were: ulcers in 70.6% of the all cases, strictures in 14.5%, cobblestone pattern 18.3%, “skip lesions” in
11.1%, non-perineal fistulas in 1% of cases. By Montreal phenotype classification, patients are grouped in
relatively equal proportions from 17 to 40 years and over 40 years; 56.6% of the cases were colonic
disease, 32.2% ileocolonic disease and 11.2% small bowel disease; 72.2% of the cases were nonpenetrating/
non-stricturing, 14.5% stricturing, and penetrating 13.3%; perineal disease was present in
10% of the cases (56% fistulas and 44% abscesses). Conclusions: Although symptoms and signs at onset
and endoscopic lesions are similar to those described in literature, the Montreal phenotype classification
results confirm the previous studies that attest in Romania a late onset, a predominance of colonic disease
and of non-penetrating/non-stricturing behavior and a reduced incidence of perianal disease. Most cases
are moderately active CD, followed in relatively equal proportions by cases with mildly active and inactive
CD. Percentage of severely active CD was very low compared with literature data. These data confirm the
existence of a particular phenotype of CD in Romania.
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