Crohn’s disease in children. Clinical case

Abstract

Crohn’s disease (CD) is a chronic relapsing disease characterized by transmural granulomatous-ulcerative inflammation affecting some or all parts of the gastrointestinal tract. Purpose - to acquaint practicing doctors with the features of the manifestations, differential diagnosis and course of CD in children. The features of the differential diagnosis and clinical course of CD are given. The basic diagnostic value of complaints, anamnesis, clinical picture, laboratory and instrumental methods of research, histological study of a biopsy of the cecum and appendix is highlighted. Microscopic examination of the cecum biopsy revealed the presence of a corrugated surface of the mucous membrane of the large intestine with focally slightly disturbed histoarchitectonics: crypts of various sizes and shapes, some with an unevenly expanded lumen. The cellular composition of the crypts is represented by colonocytes and goblet cells with reduced mucus formation, the presence of single crypt abscesses. Own plate with foci of fibrosis, unevenly infiltrated with lymphocytes, plasma cells, segmented nuclear neutrophils, eosinophils, basal plasmacytosis is noted. The muscle plate is slightly thickened, with uneven full blood vessels, infiltrated with lymphocytes, plasma cells, segmented neutrophils, with the presence of single lymphoid follicles (“incomplete granulomas”). The morphological picture may correspond to CD (taking into account endoscopic, clinical, anamnestic and other data). The research was carried out in accordance with the principles of the Declaration of Helsinki. Informed consent of the child’s parents was obtained for the research. No conflict of interests was declared by the authors.