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우리나라에서의 Crohn 병 - 임상적 , 병리학적 고찰 및 치료에 따른 경과 관찰 -
이종균(Jong Kyun Lee),김유철(You Cheoul Kim),김재준(Jae Jun Kim),이풍렬(Poong Lyul Rhee),최상운(Sang Woon Choi),정현채(Hyun Chae Jung),윤용범(Yong Bum Yoon),송인성(In Sung Song),최규완(Kyoo Wan Choi),김정룡(Chung Yong Kim),이승숙(Seu 대한내과학회 1991 대한내과학회지 Vol.41 No.5
N/A Crohn's disease used to be recognized as a rare inflammatory bowel disease in Korea, but current accumula- tion of sporadic case reports suggests a gradual increase of its inridence. Systemic studies, however, with clinical follow-up after treatment have not been fully assessed in the era of advanced colonoscopic approach. This article describes the clinical and pathologic findings of 15 cases of Cron's disease together with their clinical follow-ups with medical therapy, experienced during a period from October, 1978 to July, 1990. The results are summarized as follows: 1) The male-to-female ratio was 3,1, and the mean age was 25.5 years. The duration of symptoms was 2 months to 4 years, and the mean duration was 26 months. Common symptoms and signs included diarrhea, abdominal pain, weight loss, fever, etc., and the extraintestinal manfestations were rather scarce in these study cases. Anemia, increased ESR, throm-bocytosis, and hypoalbuminemia were frequent findings. 2) Colonoscopic and/or radiologic studies showed skipped lesion (80%), cobblestone appearance (67%), and longitudinal ulcer (47%) in order of frequency. The most common involved sites were the small bowel alone (27%), ileocolitis (60%), and the colon alone (13%). 3) Most of the patients (67%) responded well to medical therapy for a short-term period, and there was a good correlation between the subjective symptoms, colonscopic or radiologic findings, and Crohn's disease activity index. 4) Compared with cases from Western countries, the sex ratio in this study showed a male predominance, extraintestinal manifestation was rare, many patients (53%) had a past medical history of failure with anti-tuberculosis medication, and a good correlation existed between the subjective symptoms an6 objective examination. With the above findings, we assume that Crohn's disease is still a rare inflammatory bowel disease in Korea which requires a differential diagnosis with intestinal tuberculosis. It also seems more likely that in patients with clinical features of intestinal tuberculosis but who did not show any evidence of clinical improvement, including objective findings of intestinal ulcer, in spite of prolonged anti-tuberculosis medication lasting for several months, a possibility of Crohn's disease should be considered.
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