Nonspecific ulcerative colitis ― it is a disease that is characterized by certain complications and a progressive illness course. [1,2]. It has become a critical issue in society especially the development of the disease in children. The disease has a negative effect on child's lifestyle and might lead to a physical disability. Those sorts of outcomes demonstrate the seriousness importance of this disease [3,4,5].
Project goal (agenda): Determine necessity of the glucocorticoid treatment of nonspecific ulcerative colitis in children.
Research obligations:
-S Identification of areas of children colon harmed by nonspecific ulcerative colitis and systemic manifestations of the disease ;
-S Determine end results of the glucocorticoid treatment of nonspecific ulcerative colitis in children
Research methods:
-S the anamnesis data
-S objective medical examination
-S Clinical blood analysis (red blood cells, hemoglobin, white blood cells and platelet number, erythrocyte sedimentation rate( ESR))
-S Biochemical blood analysis (total bilirubin , C-reactive protein)
-S Colonoscopy results
Description of the research materials
22 children with nonspecific ulcerative colitis were examined in the Scientific Center of Pediatrics and Children Surgery. 13 (60%) of those children were males and 9 (40%) were females.
- child of them (4.5%) had colitis with the allergic reactions 1 child (4.5%) – colitis with articular syndrome 20 children (91%) had chronic colitis
In our project the age of the patients at the beginning of the disease: 40% (9) – 3-7, 23% (5) - 7-14, 23% (5) - children under one year, 13,6% (3) – 1-3.
The most clinical signs of the nonspecific ulcerative colitis: Weight loss - 55% (12), fever - 9% (2), diarrhea - 14% (3), fecal blood- 77% (17) (chart.1).
Diagnosis is based on laboratory tests сііпісаі blood analysis (red blood cells, hemoglobin, white blood cells and platelet number, ESR), biochemical blood analysis (total bilirubin , C-reactive protein) and the colonoscopy results.
Medical treatment:.
64% of the patients were prescribed salofalc, and the rest 36% salofalc+prednisolone.
The clinical symptoms change dynamics: weight loss was decreased from 55% to 27%. Fecal blood dramatically plummeted from 77% to 0%. Also both fever and diarrhea were driven to zero. (chart.2).
The blood test change dynamics: ESR went down by half from 55% to 27%. Leukocytosis was decreased from 23% to 9% . Anemia slightly went down from 18% to 14%. Thrombocytosis was cut from
27% to 18%. CPR was slightly reduced from 9% to 5%. Total bilirubin was completely eliminated (chart.3).
Chart 3 After treatment 86% of patients had a positive effect. The rest 14% had no changes. The weight loss was decreased from 55% to 21% after the salofalc treatment, and was completely eliminated after the salofalc+prednisolone treatment. Fever diarrhea and fecal blood were completely eliminated after both treatments.
The salofalk treatment showed the outstanding results by driving all the blood test results to zero, except CPR. Whereas the salofalk+ prednisolone treatment had results as follows:
- ESR was reduced from 55% to 27%
- Leukocytosis was decreased from 23% to 9%
- Anemia slightly went down from 18% to 14%
- Thrombocytosis was cut from 27% to 18%
- CPR was slightly reduced from 9% to 5%
- Total bilirubin was completely eliminated
After treatment 86% of patients had a positive effect. The rest 14% had no changes, because they didn't receive prednisolone. Subsequently after inclusion of prednisolone, in 8 of them, the results were positive and achieved remission.
Conclusion:
- The clinical-laboratory data of 86% of the children with nonspecific ulcerative colitis got better. The rest 14% had their clinical-laboratory data unchanged.
- Indications to use the combination of salofalc+prednisolon for children with nonspecific ulcerative colitis depend on the severity of the disease, a strong weight loss, fever and on changes in laboratory data (high ESR).
REFERENCES
- Федулова Э.Н. Прогноз течения и оценка эффективности лечения неспецифического язвенного колита у детей. - Автореф. дисс. … к.м.н. – Москва. – 2005. – 25 с.
- Malakhinova N.A. clinical features of nonspecific ulcerative colitis and crohn's disease in children //Saratov Journal of medical scientific Research. 2010; 6(3): 650–653.
- П.Л. Щербаков. Воспалительные заболевания кишечника у детей: болезнь Крона и неспецифический язвенный колит. // Детский доктор, 2000. - 4. - C. 22-26.
- Richard J Farrell, Mark A Peppercorn, Ulcerative colitis, The Lancet: January 26, 2002. - P. 359:331.
- Маев И.В., Гажднева М.Г., Овчинникова Н.И., Опыт применения циклоферона в комплексной терапии больных неспецйифическим язвенным колитом.//Российский журнал гастроэнтерологии, гепатологии, колопроктологии.-2001.-т.11. - №5. - 54 c.