Ref Number = PITIKA-ASPR0394
Yusri Dianne Jurnalis, Muhammad Iqbal Rivai, Nolitriani, Yorva Sayoeti
Background. The inflammatory bowel diseases (IBDs) including ulcerative colitis and Crohn’s disease, are chronic inflammatory disorders of the gastrointestinal tract most often diagnosed in adolescence and young adulthood. Approximately 25% of patients with IBD present before age 20 years, with 4% present before age 5 years and 18% before age 10 years, the peak onset in adolescence. Children can present with the classic symptoms of weight loss, abdominal pain, and bloody diarrhea, many present with nonclassic symptoms of isolated poor growth, anemia, or other extraintestinal manifestations. Crohn disease may involve the entire gastrointestinal tract from mouth to the perianal area with the incidence is approximately 10 per 100 000 children.
Case. A fifteen years old boy came to DR. M. Djamil Padang Hospital with chief complaint abdominal pain since 5 days before admission. His suffered from bloody diarrhea and sometimes blackish since 4 days before admission. There was body weight decline, nausea and vomiting since 3 weeks before admission with marasmic severe malnutrition type of nutritional status. He got microcytic hypochromic anemia due to iron deficiency based on laboratory examination. Histopatology showed that the rectal mucosal tissue covered by goblet-celled columnar epithelium, lymphocytes and plasma cells at the layer of lamina propria. He was performed colonoscopy with the result of cobblestone like appearance along the colon mucosa. He got parenteral nutrition, sulfasalazine for 7 weeks and methylprednisolone for 4 weeks with good outcome.
Conclusion. The clinical manifestations of Crohn’s disease are variable, such as prolonged diarrhea, abdominal pain, with or without gross bleeding, fatigue, and weight loss. Esophagogastroduodenoscopy and colonoscopy with biopsy remain the criterias standard for the diagnosis. The goals of Crohn‘s disease treatment consist of eliminating symptoms, normalizing quality of life, restoring growth and preventing complications while minimizing the adverse effects of medications.
Keywords: Crohn's disease, marasmic malnutrition, sulfasalazine, methylprednisolone
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