Diffuse jejuno-ileitis of Crohn's disease: a peculiar form of the disease?

Background and aims - Diffuse jejuno-ileitis of Crohn's disease may be a ho mogeneous clinical subgroup. The aim of this work wets to compare the demog raphic and clinical data at diagnosis and the initial treatments of patient s with diffuse jejuno-ileitis of Crohn's disease and to the ones without th is localization. Patients and methods - For demographic and clinical studies, 48 (32M/16F) i ncident cases of diffuse jejuno-ileitis of Crohn's disease diagnosed betwee n 1988 and 1994 in the EPIMAD register were compared with 96 (48M/48F) cont rols diagnosed the same year As far as for the therapeutic management, the 48 incident cases were compared with 48 controls. Results - Diffuse jejuno-ileitis constituted 3.3% of the total incident cas es. Median age at diagnosis was significantly lower (20 vs 23 years, P=0.01 ) and an upper digestive involvement was more frequent (56% vs 34%, P=0.03) in patients with diffuse jejuno-ileitis. These patients were more often tr eated by total parenteral nutrition (43.8% vs 19.6%, P=0.01) or azathioprin e (50% vs 20.8%, P=0.005). Azathioprine was also introduced earlier (20.7 v s 40.3 months, P=0.009). Surgery for resection was less often required in d iffuse jejuno-ileitis than in controls (65.2% vs 99.8%, P=0.02) while more stricturoplasties were performed (52.9% vs 10%, P=0.003); overall surgical rates did not significantly differ in the 2 groups. Conclusion - Our series suggest that diffuse jejuno-ileitis of Crohn's dise ase is a subgroup of patients characterized by a young age at diagnosis, wi th more frequent and earlier requirement for azathioprine.