The First Case of Schaumann Bodies in Pediatric Very Early Onset Crohn's Disease: Case Report and Literature Review.

IF 2 4区 医学 Q2 PEDIATRICS Children-Basel Pub Date : 2024-10-06 DOI:10.3390/children11101216
Jovan Jevtić, Miloš Đuknić, Nevena Popovac, Nina Ristić, Ivan Milovanovich, Milica Radusinović, Irena Đordjić, Ljubica Simić, Gorana Nikolić, Maja Životić, Ana Mioljević, Nikola Bogosavljević, Radmila Janković
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Abstract

Crohn's disease (CD) is a chronic inflammatory bowel condition with increasing global incidence. Diagnosing CD is challenging and requires close collaboration between clinicians and pathologists due to the lack of specific diagnostic criteria. Histologically, CD is characterized by transmural inflammation, crypt distortion, metaplasia, and granulomas, although granulomas are not always present. Schaumann bodies (SB), initially described in sarcoidosis, are rare in CD but have been reported in about 10% of cases. This case report presents a 4-year-old female with chronic hemorrhagic diarrhea, severe anemia, and elevated inflammatory markers. Endoscopic and histological evaluations suggested CD, with the presence of SB in the gastric mucosa. Further investigations ruled out sarcoidosis, confirming a diagnosis of multi-segmental, very early onset CD with atypical histological features. SB are inclusions composed of calcium carbonate crystals and conchoid bodies, typically found within giant cells. The presence of SB in the mucosa is rare, limiting their diagnostic significance in endoscopic biopsies. Differential diagnosis should exclude other granulomatous diseases such as intestinal tuberculosis and sarcoidosis. This case highlights the importance of considering SB in the diagnosis of CD, particularly in pediatric patients.

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小儿极早期克罗恩病中的首个肖曼体病例:病例报告和文献综述。
克罗恩病(CD)是一种慢性炎症性肠病,在全球的发病率不断上升。由于缺乏特定的诊断标准,CD 的诊断具有挑战性,需要临床医生和病理学家密切合作。从组织学角度看,CD 的特征是跨膜炎症、隐窝变形、变性和肉芽肿,但肉芽肿并不总是存在。最初在肉样瘤病中描述的肖曼体(SB)在 CD 中很少见,但有报道称约有 10%的病例出现过。本病例报告了一名患有慢性出血性腹泻、严重贫血和炎症指标升高的 4 岁女性。内镜和组织学评估显示该患者患有 CD,胃黏膜存在 SB。进一步检查排除了肉样瘤病,确诊为多节段、发病极早、组织学特征不典型的 CD。SB是由碳酸钙结晶和絮状体组成的内含物,通常存在于巨细胞内。在粘膜中出现 SB 的情况很少见,这限制了其在内窥镜活检中的诊断意义。鉴别诊断应排除其他肉芽肿性疾病,如肠结核和肉样瘤病。本病例强调了在诊断 CD 时考虑 SB 的重要性,尤其是在儿童患者中。
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来源期刊
Children-Basel
Children-Basel PEDIATRICS-
CiteScore
2.70
自引率
16.70%
发文量
1735
审稿时长
6 weeks
期刊介绍: Children is an international, open access journal dedicated to a streamlined, yet scientifically rigorous, dissemination of peer-reviewed science related to childhood health and disease in developed and developing countries. The publication focuses on sharing clinical, epidemiological and translational science relevant to children’s health. Moreover, the primary goals of the publication are to highlight under‑represented pediatric disciplines, to emphasize interdisciplinary research and to disseminate advances in knowledge in global child health. In addition to original research, the journal publishes expert editorials and commentaries, clinical case reports, and insightful communications reflecting the latest developments in pediatric medicine. By publishing meritorious articles as soon as the editorial review process is completed, rather than at predefined intervals, Children also permits rapid open access sharing of new information, allowing us to reach the broadest audience in the most expedient fashion.
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