Clinical Analysis and Identification of Pediatric Patients with Colonic Ulceration

Abstract

Background A wide variety of diseases mimic inflammatory bowel disease (IBD). This study aimed to reduce the misdiagnosis among children with colonic ulcers, unfolding the pediatric disease profiles. Methods Eighty-six pediatric patients with colonic ulcers detected by colonoscopy were enrolled in the retrospective study. Children were divided into different groups according to the final diagnosis. The clinical characteristics, laboratory examinations and histopathological results were compared between the groups. Results IBD (n = 37) was just responsible for 43% of patients with colonic ulceration. Other diagnosis mainly included autoimmune diseases (n = 9), infectious enteritis (n = 13), gastrointestinal allergy (n = 8), and other diseases (n = 19). Comparing IBD and non-IBD groups, children with IBD had a higher frequency of symptoms like weight loss/failure to thrive (P < 0.001), perianal lesions (P = 0.001), and oral ulcers (P = 0.022), and higher expression levels of platelet (P = 0.006), neutrophil-to-lymphocyte (P = 0.001), erythrocyte sedimentation rate (P < 0.001), C-reactive protein (P < 0.001), Immunoglobulin G (P = 0.012), Interleukin-1β (P = 0.003), IL-6 (P = 0.024) and TNF-α (P = 0.026). Otherwise, expression levels of hemoglobin (P < 0.001) and albumin (P = 0.001) were lower in IBD patients. Besides, a wider ulcer range distribution in the lower gastrointestinal tract was found in the IBD group (P < 0.001). Conclusions We displayed potential indicators (like platelet, neutrophil-to-lymphocyte ratio and ulcer distribution character) to help diagnose pediatric IBD with colonic ulcers differentiating from other disorders more prudent.