Pediatric Crohn’s disease in Tunisia

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Published Jan 16, 2014
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Vol. 91 No. 12 (2013): Issue Dec 2013

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N. Siala
A. Benzarti
S. Boukthir
I. Brini
A. Sammoud
S. Bousnina
S. Ben Becher
R. Lakhoua
B. Fethi
A. Harbi
N. Gueddiche
T. Sfar
M. Hachicha
M. Ben Hariz
A. Maherzi

Abstract

Crohn’s disease occur mainly in adults. However, pediatric onset forms are not rare and have many characteristics.
Aim: to study clinical, diagnostic, therapeutic and evolutive characteristics of crohn’s disease in tunisian children.
Methods: Retrospective multicenter study conducted in 10 pediatric departments on a period of 10 years (2000-2008)
Results : 43 children were included. The sex-ratio was 1.68. The mean age at the onset of the symptoms was 11+/-2.3 years (5-16 years). The age of onset was inferior to 10 years in 25 % of the children. The delay before management was superior to 1 year in 25% of cases. The initial symptoms were dominated by diarrhea (95%). Perineal manifestations were present at diagnosis in 30% of children and extra-digestive manifestations in 53%. Ileocolonic localization was the most frequent (46%). The initial disease flare was moderate in 83% of cases. The treatment was medical in 77 % of cases, nutritional and medical in 18.5%. Maintenance therapy was instituted in 86% of cases and consisted essentiallay in azathioprin (62%). The mean follow-up was 3 years and 4 months. 60% of the children had at least one acute flare. During evolution, 7% of children had anoperineal surgery and 11% an intestinal resection.
Conclusion: Crohn’s disease seems rare in Tunisia. The time of diagnosis is often delayed. The management is based on immunosuppressive therapy and nutritional support.

Keywords:

Crohn's disease, child, treatment, Outcome

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