Year 2016 / Volume 108 / Number 9
Case Report
Metastatic Crohn’s disease in pediatrics

598-603

DOI: 10.17235/reed.2016.3948/2015

Javier Blasco Alonso, Francisco Girón Fernández-Crehuet, Miguel A. Lendínez Ramírez, Sivia Gallego Gutiérrez, Silvia Luque Pérez, Juliana Serrano Nieto, Víctor M. Navas López, Carlos Sierra Salinas,

Abstract
Introduction and objectives: Metastatic Crohn’s disease (MCD) is an extraintestinal manifestation of Crohn’s disease, with biopsy as fundamental diagnostic tool. There are few references to MCD in children, with a 0.5-1% estimated incidence in adults. There is no consensus about its therapeutic approach. We describe our diagnostic and therapeutic experience in MCD. Results: Four cases of MCD are described in our Pediatric Gastroenterology Unit in a tertiary care hospital. The age at diagnosis was between 7 and 13 years. Lesions appeared before the diagnosis of Crohn’s disease in three of them, and during the course of the disease in another one, with genital location in three patients and bilateral pretibial region in the other. All four cases demonstrated non-caseificant granulomas on biopsy. Only two patients used exclusive enteral nutrition therapy with complete resolution, while other two cases received a combination of therapies (corticosteroids, azathioprine, tacrolimus, infliximab and adalimumab) because of recurrence. Only one case required surgery after poor clinical control. Conclusion: The MCD is infrequent but must always be included in the differential diagnosis of cutaneous lesions in Crohn’s disease, considering it could be the debut of the disease. We will rely on biopsy anyway for definitive diagnosis. In this series the genital region is verified as the most commonly affected in children. The therapeutic approach does not differ from the management of intestinal involvement.
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Blasco Alonso J, Girón Fernández-Crehuet F, Lendínez Ramírez M, Gallego Gutiérrez S, Luque Pérez S, Serrano Nieto J, et all. Metastatic Crohn’s disease in pediatrics. 3948/2015


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Publication history

Received: 29/07/2015

Accepted: 01/08/2015

Online First: 09/02/2016

Published: 06/09/2016

Article revision time: 2 days

Article Online First time: 195 days

Article editing time: 405 days


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