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Initial Abdominal CT and Laboratory Findings Prior to Diagnosis of Crohn's Disease in Children

 Choeum Kang  ;  Haesung Yoon  ;  Sowon Park  ;  Jisoo Kim  ;  Kyunghwa Han  ;  Seung Kim  ;  Hong Koh  ;  Mi-Jung Lee  ;  Hyun Joo Shin 
 YONSEI MEDICAL JOURNAL, Vol.63(7) : 675-682, 2022-07 
Journal Title
Issue Date
Adolescent ; Albumins ; Child ; Crohn Disease* / diagnostic imaging ; Enterocolitis* ; Humans ; Retrospective Studies ; Tomography, X-Ray Computed / methods
Crohn disease ; adolescent ; child ; early diagnosis ; tomography, X-ray computed
Purpose: To identify initial abdominal computed tomography (CT) and laboratory findings prior to a diagnosis of Crohn's disease (CD) in children.

Materials and methods: In this retrospective study, patients (≤18 year-old) who were diagnosed with CD from 2004 to 2019 and had abdominal CT just prior to being diagnosed with CD were included in the CD group. Patients (≤18 years old) who were diagnosed with infectious enterocolitis from 2018 to 2019 and had undergone CT prior to being diagnosed with enterocolitis were included as a control group. We assessed the diagnostic performances of initial CT and laboratory findings for the diagnosis of CD using logistic regression and the area under the curve (AUC).

Results: In total, 107 patients (50 CD patients, 57 control patients) were included, without an age difference between groups (median 13 years old vs. 11 years old, p=0.119). On univariate logistic regression analysis, multisegmental bowel involvement, mesenteric vessel engorgement, higher portal vein/aorta diameter ratio, longer liver longitudinal diameter, lower hemoglobin (≤12.5 g/dL), lower albumin (≤4 g/dL), and higher platelet (>320×103/µL) levels were significant factors for CD. On multivariate analysis, multisegmental bowel involvement [odds ratio (OR) 111.6, 95% confidence interval (CI) 4.778-2605.925] and lower albumin levels (OR 0.9, 95% CI 0.891-0.993) were significant factors. When these two features were combined, the AUC value was 0.985 with a sensitivity of 96% and specificity of 100% for differentiating CD.

Conclusion: Multisegmental bowel involvement on CT and decreased albumin levels can help differentiate CD from infectious enterocolitis in children prior to a definite diagnosis of CD.
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1. College of Medicine (의과대학) > Dept. of Pediatrics (소아과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Koh, Hong(고홍) ORCID logo https://orcid.org/0000-0002-3660-7483
Kim, Seung(김승) ORCID logo https://orcid.org/0000-0003-4373-9828
Kim, Jisoo(김지수)
Park, So Won(박소원) ORCID logo https://orcid.org/0000-0002-2498-8004
Shin, Hyun Joo(신현주) ORCID logo https://orcid.org/0000-0002-7462-2609
Yoon, Haesung(윤혜성) ORCID logo https://orcid.org/0000-0003-0581-8656
Lee, Mi-Jung(이미정) ORCID logo https://orcid.org/0000-0003-3244-9171
Han, Kyung Hwa(한경화)
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