儿童克罗恩病早期筛查和诊断研究进展

doi:10.12372/jcp.2023.22e0604

Abstract

Abstract:

Crohn's disease (CD) is a chronic nonspecific gastrointestinal inflammatory disease. The onset of CD in children is insidious, the clinical manifestations are lack of specificity, and early diagnosis is difficult, which leads to the increased complications, surgical rates and disability rates. Early screening and diagnosis, timely intervention can improve the therapeutic effect and prognosis of children, and improve the life quality of children. This article reviews the progress of early screening and diagnosis of CD in children.

Key words: Crohn's disease, serum marker, intestinal microorganisms, metabonomics, child

Reviewer: WANG Chenhui, Reviser: YANG Hui. Research progress on early screening and diagnosis of Crohn's disease in children[J].Journal of Clinical Pediatrics, 2023, 41(9): 708-714.

References 47

[1]	中华医学会儿科学分会消化学组, 中华医学会儿科学分会临床营养学组. 儿童炎症性肠病诊断和治疗专家共识[J]. 中华儿科杂志, 2019, 57(7): 501-507.
[2]	Kuenzig ME, Fung SG, Marderfeld L, et al. Twenty-first century trends in the global epidemiology of pediatric-onset inflammatory bowel disease: systematic review[J]. Gastroenterology, 2022, 162(4): 1147-1159. doi: 10.1053/j.gastro.2021.12.282 pmid: 34995526
[3]	Ricciuto A, Fish JR, Tomalty DE, et al. Diagnostic delay in Canadian children with inflammatory bowel disease is more common in Crohn's disease and associated with decreased height[J]. Arch Dis Child, 2018, 103(4): 319-326. doi: 10.1136/archdischild-2017-313060 pmid: 28794097
[4]	Ricciuto A, Mack DR, Huynh HQ, et al. Diagnostic delay is associated with complicated disease and growth impairment in paediatric Crohn's disease[J]. J Crohns Colitis, 2021, 15(3): 419-431. doi: 10.1093/ecco-jcc/jjaa197
[5]	赵茜茜, 李中跃. 2018年欧洲儿童胃肠病学、肝病学和营养协会波尔图炎症性肠病组关于儿童炎症性肠病内镜检查指导意见解读[J]. 临床儿科杂志, 2020, 38(5): 395-399.
[6]	Fraquelli M, Castiglione F, Calabrese E, et al. Impact of intestinal ultrasound on the management of patients with inflammatory bowel disease: how to apply scientific evidence to clinical practice[J]. Dig Liver Dis, 2020, 52(1): 9-18. doi: 10.1016/j.dld.2019.10.004
[7]	Dilillo D, Zuccotti GV, Galli E, et al. Noninvasive testing in the management of children with suspected inflammatory bowel disease[J]. Scand J Gastroenterol, 2019, 54(5): 586-591. doi: 10.1080/00365521.2019.1604799
[8]	Kang C, Yoon H, Park S, et al. Initial abdominal CT and laboratory findings prior to diagnosis of Crohn's disease in children[J]. Yonsei Med J, 2022, 63(7): 675-682. doi: 10.3349/ymj.2022.63.7.675 pmid: 35748079
[9]	Nardo GD, Esposito G, Ziparo C, et al. Enteroscopy in children and adults with inflammatory bowel disease[J]. World J Gastroenterol, 2020, 26(39): 5944-5958. doi: 10.3748/wjg.v26.i39.5944
[10]	Schooler GR, Hull NC, Mavis A, et al. MR imaging evaluation of inflammatory bowel disease in children: where are we now in 2019[J]. Magn Reson Imaging Clin N Am, 2019, 27(2): 291-300. doi: S1064-9689(19)30007-8 pmid: 30910099
[11]	Sieczkowska-Golub J, Marcinska B, Dadalski M, et al. Usefulness of colon assessment by magnetic resonance enterography in pediatric patients with inflammatory bowel disease-retrospective case series[J]. J Clin Med, 2021, 10(19): 4336. doi: 10.3390/jcm10194336
[12]	Dillman JR, Smith EA, Sanchez RJ, et al. Pediatric small bowel Crohn disease: correlation of US and MR enterography[J]. Radiographics, 2015, 35(3): 835-848. doi: 10.1148/rg.2015140002 pmid: 25839736
[13]	Hakim A, Alexakis C, Pilcher J, et al. Comparison of small intestinal contrast ultrasound with magnetic resonance enterography in pediatric Crohn's disease[J]. JGH Open, 2020, 4(2): 126-131. doi: 10.1002/jgh3.12228 pmid: 32280754
[14]	唐晓艳, 李正红, 董梅, 等. 54例儿童克罗恩病肠外表现和肠道并发症分析[J]. 中国当代儿科杂志, 2020, 22(5): 478-481.
[15]	倪耿欢, 赵宏伟, 亓昌珍, 等. 克罗恩病肛瘘与非克罗恩病肛瘘的MRI特征对比分析[J]. 中华放射学杂志, 2019, 53(4): 305-309.
[16]	杨辉, 金玉, 李玫, 等. 儿童炎症性肠病生物学标志物检测及其临床意义[J]. 临床儿科杂志, 2016, 34(10): 721-725.
[17]	Ashton JJ, Harden A, Beattie RM. Paediatric inflammatory bowel disease: improving early diagnosis[J]. Arch Dis Child, 2018, 103(4): 307-308. doi: 10.1136/archdischild-2017-313955 pmid: 29175974
[18]	尹杨艳, 陈丹丹, 桂冬梅. 粪便炎症指标检测对儿童炎症性肠病的诊断价值[J]. 中国临床医生杂志, 2021, 49(4): 487-490.
[19]	Mizuochi T, Arai K, Kudo T, et al. Antibodies to Crohn's disease peptide 353 as a diagnostic marker for pediatric Crohn's disease: a prospective multicenter study in Japan[J]. J Gastroenterol, 2020, 55(5): 515-522. doi: 10.1007/s00535-019-01661-y pmid: 31980893
[20]	Shpoliansky M, Roggenbuck D, Pinsker M, et al. Antibodies against glycoprotein 2 are specific biomarkers for pediatric Crohn's disease[J]. Dig Dis Sci, 2021, 66(8): 2619-2626. doi: 10.1007/s10620-020-06589-5
[21]	Deutschmann C, Sowa M, Murugaiyan J, et al. Identification of chitinase-3-like protein 1 as a novel neutrophil antigenic target in Crohn's disease[J]. J Crohns Colitis, 2019, 13(7): 894-904. doi: 10.1093/ecco-jcc/jjz012 pmid: 30753386
[22]	Alamdari-Palangi V, Vahedi F, Shabaninejad Z, et al. microRNA in inflammatory bowel disease at a glance[J]. Eur J Gastroenterol Hepatol, 2021, 32(2): 140-148.
[23]	Szűcs D, Béres NJ, Rokonay R, et al. Increased duodenal expression of miR-146a and -155 in pediatric Crohn's disease[J]. World J Gastroenterol, 2016, 22(26): 6027-6035. doi: 10.3748/wjg.v22.i26.6027
[24]	Judit Béres N, Kiss Z, Müller KE, et al. Role of microRNA-223 in the regulation of poly (ADP-ribose) polymerase in pediatric patients with Crohn's disease[J]. Scand J Gastroenterol, 2018, 53(9): 1066-1073. doi: 10.1080/00365521.2018.1498915
[25]	Jabandziev P, Bohosova J, Pinkasova T, et al. The emerging role of noncoding RNAs in pediatric inflammatory bowel disease[J]. Inflamm Bowel Dis, 2020, 26(7): 985-993. doi: 10.1093/ibd/izaa009 pmid: 32009179
[26]	Cui G, Fan Q, Li Z, et al. Evaluation of anti-TNF therapeutic response in patients with inflammatory bowel disease: current and novel biomarkers[J]. EBioMedicine, 2021, 66: 103329. doi: 10.1016/j.ebiom.2021.103329
[27]	Torres J, Petralia F, Sato T, et al. Serum biomarkers identify patients who will develop inflammatory bowel diseases up to 5 years before diagnosis[J]. Gastroenterology, 2020, 159(1): 96-104. doi: S0016-5085(20)30327-9 pmid: 32165208
[28]	Starr AE, Deeke SA, Ning Z, et al. Proteomic analysis of ascending colon biopsies from a paediatric inflammatory bowel disease inception cohort identifies protein biomarkers that differentiate Crohn's disease from UC[J]. Gut, 2017, 66(9): 1573-1583. doi: 10.1136/gutjnl-2015-310705 pmid: 27216938
[29]	Sila S, Jelić M, Trivić I, et al. Altered gut microbiota is present in newly diagnosed pediatric patients with inflammatory bowel disease[J]. J Pediatr Gastroenterol Nutr, 2020, 70(4): 497-502. doi: 10.1097/MPG.0000000000002611
[30]	Kansal S, Catto-Smith AG, Boniface K, et al. The microbiome in paediatric Crohn's disease-a longitudinal, prospective, single-centre study[J]. J Crohns Colitis, 2019, 13(8): 1044-1054. doi: 10.1093/ecco-jcc/jjz016
[31]	Kowalska-Duplaga K, Gosiewski T, Kapusta P, et al. Differences in the intestinal microbiome of healthy children and patients with newly diagnosed Crohn's disease[J]. Sci Rep, 2019, 9(1): 18880. doi: 10.1038/s41598-019-55290-9 pmid: 31827191
[32]	Putignani L, Oliva S, Isoldi S, et al. Fecal and mucosal microbiota profiling in pediatric inflammatory bowel diseases[J]. Eur J Gastroenterol Hepatol, 2021, 33(11): 1376-1386. doi: 10.1097/MEG.0000000000002050
[33]	Fitzgerald RS, Sanderson IR, Claesson MJ. Paediatric inflammatory bowel disease and its relationship with the microbiome[J]. Microb Ecol, 2021, 82(4): 833-844. doi: 10.1007/s00248-021-01697-9 pmid: 33666710
[34]	Papa E, Docktor M, Smillie C, et al. Non-invasive mapping of the gastrointestinal microbiota identifies children with inflammatory bowel disease[J]. PLoS One, 2012, 7(6): e39242. doi: 10.1371/journal.pone.0039242
[35]	El Mouzan M, Wang F, Al Mofarreh M, et al. Fungal microbiota profile in newly diagnosed treatment-naïve children with Crohn's disease[J]. J Crohns Colitis, 2017, 11(5): 586-592. doi: 10.1093/ecco-jcc/jjw197 pmid: 27811291
[36]	El Mouzan MI, Korolev KS, Al Mofarreh MA, et al. Fungal dysbiosis predicts the diagnosis of pediatric Crohn's disease[J]. World J Gastroenterol, 2018, 24(39): 4510-4516. doi: 10.3748/wjg.v24.i39.4510
[37]	Kolho KL, Pessia A, Jaakkola T, et al. Faecal and serum metabolomics in paediatric inflammatory bowel disease[J]. J Crohns Colitis, 2017, 11(3): 321-334.
[38]	Daniluk U, Daniluk J, Kucharski R, et al. Untargeted metabolomics and inflammatory markers profiling in children with Crohn's disease and ulcerative colitis-a preliminary study[J]. Inflamm Bowel Dis, 2019, 25(7): 1120-1128. doi: 10.1093/ibd/izy402 pmid: 30772902
[39]	Filimoniuk A, Daniluk U, Samczuk P, et al. Metabolomic profiling in children with inflammatory bowel disease[J]. Adv Med Sci, 2020, 65(1): 65-70. doi: 10.1016/j.advms.2019.12.009
[40]	Filimoniuk A, Blachnio-Zabielska A, Imierska M, et al. Sphingolipid analysis indicate lactosylceramide as a potential biomarker of inflammatory bowel disease in children[J]. Biomolecules, 2020, 10(7): 1083. doi: 10.3390/biom10071083
[41]	Bauset C, Gisbert-Ferrándiz L, Cosín-Roger J. Meta-bolomics as a promising resource identifying potential biomarkers for inflammatory bowel disease[J]. J Clin Med, 2021, 10(4): 622. doi: 10.3390/jcm10040622
[42]	Martin FP, Su MM, Xie GX, et al. Urinary metabolic insights into host-gut microbial interactions in healthy and IBD children[J]. World J Gastroenterol, 2017, 23(20): 3643-3654. doi: 10.3748/wjg.v23.i20.3643
[43]	Yamamoto M, Shanmuganathan M, Hart L, et al. Urinary metabolites enable differential diagnosis and therapeutic monitoring of pediatric inflammatory bowel disease[J]. Metabolites, 2021, 11(4): 245. doi: 10.3390/metabo11040245
[44]	Vernia F, Valvano M, Fabiani S, et al. Are volatile organic compounds accurate markers in the assessment of colorectal cancer and inflammatory bowel diseases? A review[J]. Cancers (Basel), 2021, 13(10): 2361. doi: 10.3390/cancers13102361
[45]	Patel N, Alkhouri N, Eng K, et al. Metabolomic analysis of breath volatile organic compounds reveals unique breathprints in children with inflammatory bowel disease: a pilot study[J]. Aliment Pharmacol Ther, 2014, 40(5): 498-507.
[46]	Monasta L, Pierobon C, Princivalle A, et al. Inflammatory bowel disease and patterns of volatile organic compounds in the exhaled breath of children: a case-control study using Ion Molecule Reaction-Mass Spectrometry[J]. PLoS One, 2017, 12(8): e0184118. doi: 10.1371/journal.pone.0184118
[47]	Bosch S, van Gaal N, Zuurbier RP, et al. Differentiation between pediatric irritable bowel syndrome and inflammatory bowel disease based on fecal scent: proof of principle study[J]. Inflamm Bowel Dis, 2018, 24(11): 2468-2475. doi: 10.1093/ibd/izy151 pmid: 29788410

Research progress on early screening and diagnosis of Crohn's disease in children

RichHTML

PDF (PC)

Like

Knowledge

Abstract

Cite this article

share this article

References 47

Related Articles 15

Metrics

Comments

Recommended 0

[1]	LIN Jinfeng, CHEN Yi, DENG Yan, FENG Ai, HUANG Juan, CHEN Lizhu, XIE Jingqi, NIE Xiaojing. A comparative study on the detection of anti-Nephrin antibodies in children's nephrotic syndrome by chemiluminescence method and cell-based assay [J]. Journal of Clinical Pediatrics, 2026, 44(8): 682-689.
[2]	ZHENG Fangyuan, WANG Miao, DING Mingming, LU Aidong, JIA Yueping, ZENG Huimin, ZHANG Leping. Next-generation sequencing identified gene variants and their prognostic impact in pediatric Philadelphia chromosome positive acute lymphoblastic leukemia [J]. Journal of Clinical Pediatrics, 2026, 44(8): 690-697.
[3]	ZHANG Xiao, FANG Hongjun, KUANG Xiaojun, WANG Lijuan, WU Zhao, JIANG Sha, LI Pei, WU Liwen. Analysis of the clinical and electrophysiological characteristics of atonic seizures in children [J]. Journal of Clinical Pediatrics, 2026, 44(8): 698-704.
[4]	WANG Mengqian, YANG Hui. Case series analysis of 13 intestinal Behcet’s syndrome in children [J]. Journal of Clinical Pediatrics, 2026, 44(8): 705-711.
[5]	WU Xirong, GAO Qi, GUO Siyuan, YIN Qingqin, QIN Qiang, YIN Ju, JIAO Anxia, CHEN Chenghao, WU Di, WANG Bei, DUAN Xiaomin, PENG Yun, XU Baoping, GAO Liwei. Clinical characteristics and prognosis of pulmonary mucormycosis in children with diabetes mellitus [J]. Journal of Clinical Pediatrics, 2026, 44(8): 712-720.
[6]	HAN Yanan, GE Lanlan, CUI Jieyuan. A case report of branchio-oto-renal syndrome caused by EYA1 gene variant with a 6-year follow-up [J]. Journal of Clinical Pediatrics, 2026, 44(8): 721-726.
[7]	SHI Jiayi, GAO Chunlin, JIA Lili, LU Yunyun, SUN Tao, ZHU Xiaodong, XIA Zhengkun, ZHANG Pei. Phenotypic characteristics and prognostic analysis of a pedigree with childhood isolated nephrotic syndrome caused by compound heterozygous mutations in the COQ2 gene [J]. Journal of Clinical Pediatrics, 2026, 44(8): 727-732.
[8]	Rachel Rosen, Osvaldo Borrelli, Christophe Faure, Katja Karrento, Usha Krishnan, Samuel Nurko, Nathalie Rommel, Alan Silverman, Michiel van Wijk, Marc Benninga (Author), Chinese Medical Association Parenteral and Enteral Nutrition Branch Pediatrics Group, The Subspecialty Group of Gastroenterology, The Society of Pediatric, Chinese Medical Association, Gastroenterology Group, Pediatrician Branch, Chinese Medical Doctor Association (Translator). Core interpretation and explanation of Rome Ⅴ diagnostic criteria: upper gastrointestinal disorders of gut-brain interaction in children and adolescents [J]. Journal of Clinical Pediatrics, 2026, 44(7): 595-608.
[9]	Carlo Di Lorenzo, Miguel Saps, Bruno P. Chumpitazi, Shaman Rajindrajith, Annamaria Staiano, Nikhil Thapar, Miranda van Tilburg, Carlos Velasco-Benítez, Arine Vlieger (Author), Chinese Medical Association Parenteral and Enteral Nutrition Branch Pediatrics Group, The Subspecialty Group of Gastroenterology, The Society of Pediatric, Chinese Medical Association, Gastroenterology Group, Pediatrician Branch, Chinese Medical Doctor Association (Translator). Core interpretation and explanation of Rome Ⅴ diagnostic criteria: lower and biliary disorders of gut-brain interaction in children and adolescents [J]. Journal of Clinical Pediatrics, 2026, 44(7): 609-621.
[10]	LI Xufeng, TANG Haoxun, LI Xingjun, ZHANG Lize, GAO Chenqing, ZHAO Shunying, LIU Jianhua. Clinical characteristics, chest CT imaging phenotypes, and their correlation with prognosis in 76 children with Chlamydia pneumoniae pneumonia [J]. Journal of Clinical Pediatrics, 2026, 44(7): 622-627.
[11]	WANG Zhen, SHAO Jingbo, ZHANG Na, XIA Min, ZHU Jiashi, DU Chengkan, LI Hong. Factors influencing long-term recurrence in pediatric acute lymphoblastic leukemia patients with low-risk disease at initial diagnosis: a five-year follow-up analysis of 254 cases from a single center [J]. Journal of Clinical Pediatrics, 2026, 44(7): 628-635.
[12]	GUO Xuemei, XUE Yao, WANG Yongren, RONG Liucheng, FANG Yongjun, LIN Rufeng. Clinical features and prognosis of childhood acute myeloid leukemia with CBFA2T3::GLIS2 fusion [J]. Journal of Clinical Pediatrics, 2026, 44(7): 636-643.
[13]	YANG Lijun, FU Dongxia, CUI Yan, YANG Junmei, ZHANG Liming. Clinical manifestation and genetic analysis of CHARGE syndrome caused by CHD7 gene variation [J]. Journal of Clinical Pediatrics, 2026, 44(7): 644-650.
[14]	HU Yan, YANG Fan, LIANG Aimin, MAO Meng. Identification and management of faltering growth in children: insights from the 13th International Conference on Nutrition and Growth [J]. Journal of Clinical Pediatrics, 2026, 44(6): 485-488.
[15]	LIU Ziyao, WANG Congying, WANG Hongmao, ZHANG Mingming, XU Yingjie, LAI Jianming, NIU Wenquan, LI Xiaohui. Early differentiation of Kawasaki disease with joint symptoms and systemic juvenile idiopathic arthritis with Kawasaki disease-like symptoms: a single-center retrospective study [J]. Journal of Clinical Pediatrics, 2026, 44(6): 489-498.