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What Causes Crohn's Ileitis In Children?
Question: My 15 yr old daughter has been unwell for 5 months. It started with mild abdominal pain near the belly button and in the right lower quadrant. Over the next 4 weeks she developed nausea, fatigue, loss of appetite, headaches and multiple swollen inguinal lymph nodes. Bloodwork was normal except for eosinophil count which was 27%. Dr put her on antibiotics and anti parasite meds but no improvement. Over the past months she has had multiple blood tests, multiple abdom/pelvic ultrasounds (clear except for nodes), abdominal ct (everything was clear except for the swollen nodes), lymph node excisional biopsy (showed reactive inflammation), head ct (clear), barium swallow (clear), endoscopy (clear). Eosinophil count is down to 8%. We still do not have a diagnosis and my daughter experiences the symptoms almost all day every day and most nights. The latest tests, a colonoscopy revealed abnormal mucosa in the terminal ilium, biopsy revealed no Crohn's Disease so gastroenterologist has diagnosed ileitis. There is 5 inguinal lymph nodes about 2cm in size plus multiple that are .8mm approx and are hard, rubbery. The nodes are on both sides of the groin.
My question is, is the ileitis the cause of all symptoms or is it just another symptom of something else?
My daughter is otherwise healthy and normal weight (although she has lost 4kg during this illness).
My question is, is the ileitis the cause of all symptoms or is it just another symptom of something else?
My daughter is otherwise healthy and normal weight (although she has lost 4kg during this illness).
Brief Answer:
Illeitis unlikely to cause such symptoms
Detailed Answer:
Hi
Welcome to Healthcare-Magic
Greetings of the day
Dear Sir/Madam
Many of children have non specific enlargement of lymph nodes. If the nodes are small , non tender , non matted and XXXXXXX there are likely to be insignificant. Doing a excision biopsy will reveal non specific inflammation.
Illeitis is unlikely to be cause of symptoms, non specific Illeitis is rare in children. They usually present with diarrhea. Pain is less likely unless there is mechanical obstruction.
Also trial of Diethyl Carbamazine is worth considering for Eosinophilia.
In my clinical practise when such patient presents to me with recurrent pain : Ultrasound and CT scan and other investigation have ruled out Mal rotation, appendix , mesenteric lymph node : I proceed with diagnostic Laparoscopy. I would suggest you to discuss this with your treating Physician.
Do get back to me if you need any further assistance, will be glad to assist you.
Kindly keep me updated about the progress.
Wishing her speedy recovery.
Take care
Best Regards
Dr Deepak Kishore Kaltari
MBBS, MS, MCH
Consultant Pediatric Surgeon
Illeitis unlikely to cause such symptoms
Detailed Answer:
Hi
Welcome to Healthcare-Magic
Greetings of the day
Dear Sir/Madam
Many of children have non specific enlargement of lymph nodes. If the nodes are small , non tender , non matted and XXXXXXX there are likely to be insignificant. Doing a excision biopsy will reveal non specific inflammation.
Illeitis is unlikely to be cause of symptoms, non specific Illeitis is rare in children. They usually present with diarrhea. Pain is less likely unless there is mechanical obstruction.
Also trial of Diethyl Carbamazine is worth considering for Eosinophilia.
In my clinical practise when such patient presents to me with recurrent pain : Ultrasound and CT scan and other investigation have ruled out Mal rotation, appendix , mesenteric lymph node : I proceed with diagnostic Laparoscopy. I would suggest you to discuss this with your treating Physician.
Do get back to me if you need any further assistance, will be glad to assist you.
Kindly keep me updated about the progress.
Wishing her speedy recovery.
Take care
Best Regards
Dr Deepak Kishore Kaltari
MBBS, MS, MCH
Consultant Pediatric Surgeon
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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