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P103. Using of confocal endomicroscopy in inflammatory bowel disease of children

A.Y. Kharitonova, A.A. Shavrov, M.V. Venedictova, A.G. Talalaev, M.M. Lokhmatov, A.S. Potapov, E.G. Tsimbalova

The Scientific Center of Children's Health, Russian Academy of Medical Sciences, Moscow, Russian Federation

The object is to assess the effectiveness of confocal endomicroscopy in diagnostics of inflammatory bowel disease of children.

Materials and Methods: Colonoscopy with inspection of terminal portion of ileum and cascade biopsy with histological study was introduced to 9 children of 7–18 years old. The average age of children (8 boys and 1 girl) was 15.6±2.12 years old. 5 patients observed suffered from Crohn's disease and 4 children were observed because of the nonspecific ulcerative colitis. Endoscopic examination was followed by endomicroscopy of modified areas of the bowel mucous coat using confocal endomicroscope Cellvizio produced by Mauna Kea Technologies. Laser scanning of the mucous coat was executed using ColoFlex and UHD ColoFlex probes with monitoring depth range of 50 and 20 micrometers respectively. During the colonoscopy the patients were given the injections of fluorescein (at the rate of 5 mg to 1 kg of body weight) to get high-visibility images.

Results: Endoscopic examination showed terminal lymphfollicular ileitis at 3 children and erosive-ulcerative ileitis at 4 children observed. In 2 cases the pathology of ileum wasn't found. Erosive-ulcerative ileitis was detected at 3 children, aphthous colitis at 2 children, extensive colitis – at 2 children and unmodified colon mucous coat – at 2 children observed.

Data gathered using confocal endomicroscopy allowed to assess peristalsis rhythmicity, intercellular unions, blood capillary diameter, blood velocity, brush border continuity, lamina propria state, Paneth cells and caliciform cell number.

Endoscopic and histologic diagnosis coincidence was shown in 73%, while the coincidence of the results of confocal endomicroscopy and histological study of biopsic material was shown in 93%.

Summary: Confocal endomicroscopy is a promising optical technology which improves the efficiency of endoscopic investigation of inflammatory bowel disease of children.