Experience in Managing Children with Crohn’s Disease in a Gastroenterology Department

Crohn’s disease in children is a chronic inflammatory disorder of the gastrointestinal tract, characterized by progressive course, variable clinical manifestations, and a high risk of both systemic and local complications. In pediatric practice, the diagnosis and management of Crohn’s disease remain challenging due to the lack of specific biomarkers, the diversity of clinical presentations, and age-related characteristics of patients. The aim of this study was to analyze the clinical features, laboratory findings, disease course, and therapeutic strategies in children with Crohn’s disease based on data from a pediatric gastroenterology department registry. The study included data from 29 children with a verified diagnosis of Crohn’s disease for the period from 2009 to March 2025. A retrospective descriptive analysis of medical records was performed. Parameters assessed included age at disease onset, sex, symptom frequency, disease activity index (PCDAI), laboratory values, presence of complications, and treatment strategies, including biologic therapy. The most frequent initial symptoms were abdominal pain (100 %), weight loss (63 %), asthenic syndrome (55 %), and diarrhea (42 %). Children under 10 years of age more commonly presented with signs of pronounced inflammation, such as anemia, elevated erythrocyte sedimentation rate, C-reactive protein, and thrombocytosis. Complicated disease course was identified in 41 % of cases. The average diagnostic delay was 6.5 months. Biologic therapy was initiated in 6 patients based on strict indications. These findings highlight the importance of early diagnosis, the use of phenotypic classifications, and a multidisciplinary approach. The results may contribute to the development of clinical pathways and standards of care for pediatric Crohn’s disease.