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Use of magnetically controlled capsule endoscopy in inflammatory pediatric Crohn's disease
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DOI：10.1002/jpn3.70416.png)
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Abstract
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Objectives This study aimed to evaluate the clinical utility of magnetically controlled capsule endoscopy (MCCE) in the evaluation and management of pediatric Crohn's disease (CD).Methods A single-center retrospective cohort study was conducted on pediatric CD patients diagnosed at Shanghai Children's Hospital between October 2020 and September 2024. Clinical data, procedure completion rates, and laboratory parameters were collected. The Lewis score was applied to quantify small bowel mucosal inflammation, and correlations with the Pediatric Crohn's Disease Activity Index (PCDAI), hematologic parameters, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), inflammatory cytokines, gastric transit time (GTT), small bowel transit time (SBTT), and bowel wall thickness (BWT) were examined. Multivariate linear regression was performed to identify independent predictors of the Lewis score.Results Twenty-four children underwent 66 MCCE examinations. The detection rate of small bowel lesions reached 96.6%, with mucosal edema and ulceration as the predominant findings, while polypoid hyperplasia (6.8%) and active bleeding (3.4%) were less common. The Lewis score showed significant correlations with PCDAI, CRP, ESR, interleukin-12p70 (IL-12p70), white blood cell count (WBC), hemoglobin (Hb), and platelet count (PLT), but no significant associations with mean corpuscular volume (MCV), neutrophil count (NEUT#), fecal calprotectin (FC), tumor necrosis factor-alpha (TNF-alpha), GTT, SBTT, or BWT. Multivariate analysis identified IL-12p70 and PCDAI as independent predictors of the Lewis score. No serious adverse events occurred.Conclusions MCCE is feasible and effective for assessing small bowel and upper gastrointestinal involvement in pediatric CD. Elevated Lewis scores may reflect increased mucosal inflammation and aid in disease assessment.
Keywords:
biomarkers
disease activity
intestinal wall thickness
mucosal inflammation
pediatric endoscopy
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