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【指南】ECCO/ESPGHAN共识指南:小儿克罗恩病的医学管理
36472014/09/04 收藏

文章类型:指南原文

语言:英文

中文标题:2014 ECCO/ESPGHAN共识指南:小儿克罗恩病的医学管理

英文标题:Consensus guidelines of ECCO/ESPGHAN on the medical management of pediatric Crohn's disease.

制定者:欧洲克罗恩病和结肠炎组织(ECCO,European Cron's and Colitis Organisation)

制定日期:2014.6.5

摘要:Children and adolescents with Crohn’s disease (CD) present often with a more complicated disease course compared to adult patients. In addition, the potential impact of CD on growth, pubertal and emotional development of patients underlines the need for a specific management strategy of pediatric-onset CD. To develop the first evidenced based and consensus driven guidelines for pediatric-onset CD an expert panel of 33 IBD specialists was formed after an open call within the European Crohn’s and Colitis Organisation and the European Society of Pediatric Gastroenterolog, Hepatology and Nutrition. The aim was to base on a thorough review of existing evidence a state of the art guidance on the medical treatment and long term management of children and adolescents with CD, with individualized treatment algorithms based on a benefit-risk analysis according to different clinical scenarios. In children and adolescents who did not have finished their growth, exclusive enteral nutrition (EEN) is the induction therapy of first choice due to its excellent safety profile, preferable over corticosteroids, which are equipotential to induce remission. The majority of patients with pediatric-onset CD require
immunomodulator based maintenance therapy. The experts discuss several factors potentially predictive for poor disease outcome (such as severe perianal fistulizing disease, severe stricturing/penetrating disease, severe growth retardation, panenteric disease, persistent severe disease despite adequate induction therapy), which may incite to an anti-TNF-based top down approach.

关键词:Pediatric; Crohn's disease; Guidelines; Medical therapy

 

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