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Evaluation of diagnostic criteria for Crohn’s disease in Japan

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Abstract

Background

In Japan, Crohn’s disease (CD) is diagnosed according to a single, well-established set of diagnostic criteria. However, no nationwide attempt has been made to determine which specific criteria within these diagnostic criteria are used to make diagnoses.

Methods

A questionnaire-based survey was conducted of patients given a definitive or suspected diagnosis of CD before January 2011 according to the Japanese Diagnostic Criteria for Crohn’s Disease. The survey included 579 patients with a definitive diagnosis of CD and 59 patients with a suspected diagnosis of CD at 34 Japanese medical institutions.

Results

A total of 87.4 % of definitive diagnoses of CD were based on the criterion in the definite category: major finding A “longitudinal ulcer (LU)” or B “cobblestone-like appearance (CSA)”. A total of 30.4 % of definitive diagnoses were based on the criterion: major finding C “non-caseating epithelioid cell granuloma (NCEG)” with minor finding a “irregularshaped and/or quasi-circular ulcers or aphthous ulcerations found extensively in the gastrointestinal tract” or b “characteristic perianal lesions”. Finally, 7.1 % of definitive diagnoses were made according to the criterion: all minor findings a, b and c “characteristic gastric and/or duodenal lesions”. Among suspected diagnoses of CD, 74.6 % were based on the criterion in the suspected category: one or two minor findings.

Conclusions

The Japanese diagnostic criteria for Crohn’s disease consist of combinations of specific morphological findings. Many of the diagnoses were based on the findings of LU or CSA.

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Acknowledgments

This work was supported by Health and Labour Sciences Research Grants for Research on Intractable Disease from the Ministry of Health, Labour and Welfare of Japan.

Conflict of interest

Toshiyuki Matsui received research grants from Eisai Co., Ltd., Mitsubishi Tanabe Pharma Co., Ajinomoto Pharma- ceuticals Co., Ltd., Zeria Pharmaceutical Co., Ltd., Kyorin Pharma- ceutical Co., Ltd., JIMRO Co., Ltd., Astellas Pharma Inc.; received lecture fees from Eisai Co., Ltd. Mamoru Watanabe received research grants from abbvie.co.jp., Astellas Pharma Inc., Asahi Kasei Kuraray Medical Co., Ltd, Ajinomoto Pharma Co., Ltd, Chugai Pharmaceutical Co., Ltd, DAIICHI SANKYO CO., LTD, Eisai Co., Ltd, Kyowa Hakko Kirin Co., Ltd, Kyorin Pharmaceutical Co. Ltd, JIMRO Co.Ltd, Mitsubishi Tanabe Pharma Corporation, MSD K.K., Otsuka Pharma Co., Ltd, Takeda Pharmaceutical Co., Ltd, UCB Japan Co., Ltd, and Zeria Pharmaceutical Co., Ltd. Takashi Hisabe and Fumihito Hirai have no conflict of interest.

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Authors and Affiliations

  1. Department of Gastroenterology, Fukuoka University Chikushi Hospital, 1-1-1 Zokumyoin, Chikushino, Fukuoka, 818-8502, Japan

    Takashi Hisabe, Fumihito Hirai & Toshiyuki Matsui

  2. Department of Gastroenterology and Hepatology, Graduate School of Medicine, Tokyo Medical and Dental University, Tokyo, Japan

    Mamoru Watanabe

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  1. Takashi Hisabe
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Correspondence to Takashi Hisabe.

Appendix: Contributors in the development of the diagnostic criteria for Crohn’s disease in Japan (the Research Group of Intractable Inflammatory Bowel Disease granted by the Ministry of Health, Labour and Welfare of Japan)

Appendix: Contributors in the development of the diagnostic criteria for Crohn’s disease in Japan (the Research Group of Intractable Inflammatory Bowel Disease granted by the Ministry of Health, Labour and Welfare of Japan)

Toshiyuki Matsui (Chair); Department of Gastroenterology, Fukuoka University Chikushi Hospital, Chikushino, Japan

Takayuki Matsumoto; Department of Medicine and Clinical Science, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan

Yasuo Suzuki; Department of Gastroenterology, Toho University Sakura Medical Center, Sakura, Japan

Shinji Tanaka; Department of Endoscopy, Hiroshima University Hospital, Hiroshima, Japan

Hiroyuki Hanai; Center for Gastroenterology and Inflammatory Bowel Disease Research, Hamamatsu South Hospital, Hamamatsu, Japan

Nobuo Hiwatashi; Department of Gastroenterology, Iwaki Kyoritsu Hospital, Iwaki, Japan

Nagamu Inoue; Division of Gastorenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan

Ichiro Hirata; Department of Gastroenterology, Fujita Health University, Toyoake, Japan

Fumihito Hirai; Department of Gastroenterology, Fukuoka University Chikushi Hospital, Chikushino, Japan

Kiyonori Kobayashi; Department of Gastroenterology, Kitasato University East Hospital, Sagamihara, Japan

Nobuhide Oshitani; Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka, Japan

Toshifumi Ashida; Center for Inflammatory Bowel Disease, Sapporo Higashi Tokushukai Hospital, Sapporo, Japan

Toshiaki Watanabe; Department of Surgical Oncology and Vascular Surgery, University of Tokyo, Tokyo, Japan

Hisao Fujii; Department of Surgery, Nara Medical University, Kashihara, Japan

Akira Sugita; Department of Inflammatory bowel disease, Yokohama Municipal Citizen’s Hostipal, Yokohama, Japan

Akinori Iwashita; Department of Pathology, Fukuoka University Chikushi Hospital, Chikushino, Japan

Yoichi Ajioka; Division of Molecular and Diagnostic Pathology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan

Masanori Tanaka; Department of Pathology and Laboratory Medicine, Hirosaki Municipal Hospital, Hirosaki, Japan

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Hisabe, T., Hirai, F., Matsui, T. et al. Evaluation of diagnostic criteria for Crohn’s disease in Japan. J Gastroenterol 49, 93–99 (2014). https://doi.org/10.1007/s00535-013-0798-x

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  • DOI: https://doi.org/10.1007/s00535-013-0798-x

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