Clinical Observation Of Thalidomide In Children With Crohn’s Disease

Purpose: To evaluate the clinical efficacy and safety of thalidomide in children with Crohn ’s disease(CD).Methods: Collected from January 2013 to January 2016 in Hunan Provincial Children’s Hospital,Gastroenterology diagnosis and treatment of children with CD and the use of thalidomide treatment case data,thalidomide starting dose of 2mg / kg / day and 3 times a day The patients were followed up for 0 weeks(before treatment),4 weeks,8 weeks,12 weeks,26 weeks and 52 weeks.The calculated children’s Crohn’s disease activity score index(PCDAI),mucosal healing and histological healing,was used to evaluate the efficacy and test(Hemoglobin,erythrocyte sedimentation rate,C-reactive protein,albumin,platelet).and the monitoring Before and after treatment,the body weight was calculated by weight difference.The age-weight Z score was used to evaluate the nutritional status and growth and development of children before and after treatment.Finally,the adverse reactions occurred during follow-up treatment.Results: Clinical efficacy: a total of 12 cases of children with CD for clinical research,9 patients achieved clinical remission after 12 weeks of treatment,11 patients achieved clinical remission after 52 weeks of treatment.The mean PCDAI of 12 children at 0 weeks,4 weeks,8 weeks,12 weeks,26 weeks and 52 weeks was 41.5 ±8.7,22.8 ± 7.5,、14.3 ± 6.9,、9.5 ± 4.3、5.5±3.3、2.7±2.8,the difference was statistically significant(P <0.001)at 4 weeks,8 weeks,12 weeks,26 weeks,and 52 weeks compared with 0 weeks of treatment.The levels of ESR,CRP and PLT decreased gradually,and the levels of Hb and ALb increased gradually,and the difference was statistically significant(P <0.05).The mean age of the patients before and after treatment was-1.52,0.04,and the 12 cases of children had a significant increase in age Z score after treatment for 52 weeks.The nutritional status of 12 children was improved in different degrees Statistically significant(P <0.05).After 52 weeks of thalidomide treatment,10 of the 12 children had a down-regulated endoscopic score,with a statistically significant difference(P <0.01).41.7% of all children achieved mucosal healing,and 45.5% of the 11 patients with clinical remission achieved mucosal healing.The histological score was downregulated in 9 of 12 children,with a statistically significant difference(P <0.01).25.0% of all children achieved histological healing,11 cases of clinical remission in children with 27.3% to achieve histological healing.12 cases of children without peripheral neuropathy and other serious adverse reactions,of which the most common adverse reactions for drowsiness,dizziness,all adverse reactions occur within 2 weeks can be relieved to disappear.Conclusions:1.Thalidomide treatment of children with Crohn’s disease(CD)clinical efficacy is significant,safe,and its long-term treatment of the safety remains to be further multi-center study.2.Thalidomide treatment of children with CD can significantly promote mucosal and histological healing,improve the nutritional status of children.