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Development of Crohn disease in patients with myelodysplastic syndrome : report of two children

Korean Journal of Pediatrics 2006;49(1):107-111.
Published online January 15, 2006.
Development of Crohn disease in patients with myelodysplastic syndrome : report of two children
Jeong Ok Shim1, Jeong Kee Seo1, Hye Ran Yang1, Jae Sung Ko1, Hee Young Shin1, Hyo Seop Ahn1, Woo Sun Kim2, Gyeong Hoon Kang3
1Departments of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
2Departments of Radiology, Seoul National University College of Medicine, Seoul, Korea
3Departments of Pathology, Seoul National University College of Medicine, Seoul, Korea
골수이형성 증후군으로 진단받은 소아에서 발생한 크론병
심정옥1, 서정기1, 양혜란1, 고재성1, 신희영1, 안효섭1, 김우선2, 강경훈3
1서울대학교 의과대학 소아과학교실
2서울대학교 의과대학 진단방사선과학교실
3서울대학교 의과대학 병리학교실
Correspondence: 
Jeong Kee Seo, Email: jkseo@snu.ac.kr
Abstract
Crohn disease (CD) is rare, but the incidence of CD has been increasing over the past ten years. We found two cases of CD, associated with myelodysplastic syndrome (MDS), for the first time in children. In the first patient, MDS was diagnosed at three years of age and CD developed later at eight years of age. The patient presented with recurrent abdominal pain, diarrhea, bloody stools and failure to thrive. Colonoscopy revealed cobble stone like mucosa and mass like lesions with superficial ulceration and inflammatory exudates, observed from the cecum to ascending colon. Ileo-cecal biopsy samples showed ulcers with skipped areas and lymphoid infiltrations. The patient was started on treatment with mesalazine and deflazacort, and symptoms remitted. In the second patient, MDS was diagnosed at nine years of age and CD developed at 13 years of age. This patient has recurrent hematochezia, abdominal pain, vomiting and fever. Colonoscopy revealed a large, deep indurative ulceration on the cecal side of the ileo-cecal valve. Ileocecectomy was done, and histology revealed ulceration with transmural inflammation and lymphoid aggregates. Symptoms improved after ileocecectomy.
Key Words: Crohn disease , Myelodysplastic syndrome , Children


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