Crohn's disease in the elderly.

概要

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The distribution of age at onset in Crohn's disease in Japan reveals that the highest incidence occurs in the 20-29-year age group and that the disease occurs less frequently in older people. Recently, we experienced 2 patients older than 60 years. Case 1 was a 72-year-old man. He visited us because of diarrhea and weight loss. Case 2 was a 61-year-old woman with abdominal pain and a palpable mass in the ileocecal region. Radiographic and endoscopic examinations revealed a cobblestone appearance and longitudinal ulcers in the ileum and colon, and in biopsied specimens epithelioid cell granulomas were observed in both cases. We were able to definitely diagnose these cases as Crohn's ileocolitis.<BR>The incidence of patients older than 60 years has been reported to range from 8 to 19% in Europe and the US. The characteristic findings are summarized as follows ; 1) Distal colon involvement was common. 2) The recurrence rate after initial ileal resection was low. 3) Older patients generally had delayed diagnosis. 4) Clinical symptoms and radiographic findings were similar to those in young patients. In our series, the incidence was 2.2% and there were no differences between older and younger patients with regard to clinical symptoms, laboratory data, radiographic and endoscopic findings and histological picture.
日本大腸肛門病学会の論文