Uloga nacionalnoga registra za djecu oboljelu od upalnih bolesti crijeva u određivanju incidencije i pedijatrijskoga fenotipa bolesti u Hrvatskoj

doctoral thesis

• Title (english): The role of national registry for children with inflammatory bowel disease in determining incidence and pediatric disease phenotype in Croatia
• Author: Lana Njavro
• Mentor: Sanja Kolaček (mentor)
• Committee member: Jurica Vuković (predsjednik povjerenstva)
• Committee member: Irena Senečić-Čala (član povjerenstva)
• Committee member: Orjena Žaja (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; Zagreb
• Defense date and country: 2021-05-21, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine
• Universal decimal classification (UDC): 616 - Pathology. Clinical medicine

Abstract

Uvod: Incidencija kroničnih upalnih bolesti crijeva (KUBC) u pedijatrijskoj populaciji u cijelom svijetu raste, a za razliku od odraslih, bolest u djece ima prošireniju formu i teži klinički tijek. -----
Ciljevi: Ciljevi ovog istraživanja bili su odrediti incidenciju i fenotipska obilježja KUBC u djece u Hrvatskoj, usporediti dobivene podatke sa drugim europskim zemljama i utvrditi uklapaju li se naši podatci u ranije opisani sjeverno – južni padajući gradijent pojavnosti bolesti u Europi, a na temelju regionalne podjele Hrvatske provjeriti postoji li takav gradijent i unutar naše zemlje te opisati tijek bolesti u sklopu jednogodišnjeg praćenja novodijagnosticiranih bolesnika. -----
Ispitanici i metode: Provedeno je prospektivno, kohortno, multicentrično, opservacijsko istraživanje temeljeno na podatcima iz nacionalnog registra za djecu oboljelu od KUBC u koji su bili uključeni svi novodijagnosticirani bolesnici u dobi do 18 godina u vremenskom periodu od jedne godine. -----
Rezultati: KUBC je dijagnosticirana u 51 ispitanika od kojih je u 19 ispitanika dijagnosticirana Crohnova bolest (37,3%), u 28 ispitanika ulcerozni kolitis (54,9%), a u njih 4 neklasificirana upalna bolest crijeva (7,8%). Incidencija KUBC u Hrvatskoj iznosila je 7,05/100000 djece do 18 godina/godinu te se uklopila u sjeverno – južni padajući gradijent u Europi. Rezultati su ukazali na postojanje trenda sjeverno – južnog padajućeg gradijenta i unutar Hrvatske sa višom incidencijom u sjevernoj regiji (8,38/100000 djece do 18 godina/godinu) u odnosu na južnu (4,26/100,000 djece do 18 godina/godinu). Najčešći fenotip Crohnove bolesti bila je ileokolonična forma (52,6%), a najčešći fenotip ulceroznog kolitisa bio je pankolitis (53,6%). Preporučeni europski dijagnostički postupnik doslijedno je proveden tek u 29,4% naših ispitanika. Tijekom jednogodišnjeg praćenja 41,2% ispitanika sa Crohnovom bolesti i njih 53,9% sa ulceroznim kolitisom imalo je barem jedan relaps. -----
Zaključak: Podatci dobiveni novoutemeljenim nacionalnim registrom omogućili su utvrđivanje incidencije i fenotipa te određivanje jednogodišnje prognoze bolesti, a trebali bi pridonijeti usklađivanju i poboljšanju dijagnostičkog i terapijskog pristupa oboljeloj djeci na nacionalnoj razini.

Abstract (english)

Introduction: The incidence of pediatric inflammatory bowel disease (IBD) is increasing worldwide, and unlike adults, the disease in children shows extensive intestinal involvement and more severe clinical course. -----
Objectives: Objectives of this study were to determine the incidence and phenotype of pediatric IBD in the Republic of Croatia, to compare obtained data with other European countries and thus determine whether our data fit into previously described north-south descending gradient in Europe, to examine whether such a gradient exists within our country as well as to describe the early disease course as part of a one-year follow-up of newly diagnosed patients. -----
Patients and methods: A prospective, cohort, multicenter observational study was conducted based on data obtained from Croatian national registry for children with IBD. Children and adolescents younger than 18 years diagnosed with IBD over a one-year period were recruited. -----
Results: IBD was diagnosed in 51 patient; 19 had Crohn's disease (CD) (37.3%), 28 had ulcerative colitis (UC) (54.9%), and 4 of them had IBD – unclassified (7.8%). The incidence of pediatric IBD per 100,000 persons per year in Croatia was 7.05, and fits into the north - south descending gradient in Europe. Trend of north to south gradient was observed within Croatia as well, with a higher incidence in northern (8.38/100,000) compared to southern region (4.26/100,000). The most common phenotype of CD was an ileocolonic form of the disease (52.6%), and the most common phenotype of UC was pancolitis (53.6%). The recommended European diagnostic procedure was consistently performed only in 29.4% of our patients. During a one-year follow-up, 41.2% of CD and 53.9% of UC patients had at least one relapse.
Conclusion: The data obtained from newly established national registry have enabled determination of incidence, phenotype and one-year prognosis of pediatric IBD, and should contribute to improve diagnostic and therapeutic approaches to children with IBD at the national level.

• Keywords: kronična upalna bolest crijeva; djeca; incidencija; fenotip; Hrvatska
• Keywords (english): inflammatory bowel disease; children; incidence; phenotype; Croatia
• Language: croatian
• URN:NBN: urn:nbn:hr:105:497067
• Study programme: Title: Biomedicine and Health Sciences; Study programme type: university; Study level: postgraduate; Academic / professional title: doktor/doktorica znanosti, područje biomedicine i zdravstvo (doktor/doktorica znanosti, područje biomedicine i zdravstvo)
• Type of resource: Text
• Extent: 117 str.
• File origin: Born digital
• Access conditions: Open access
• Created on: 2021-06-24 09:39:42