Urine cotinine as a parameter of exposure to cigarette smoking in view of the clinical course of Crohn’s disease in children and adolescents – own observation

Introduction: Aetiopathogenetic factors of Crohn’s disease include genetic, autoimmunological and environmental ones. One of the significant environmental factors that modify the course of the disease is exposure to cigarette smoke. In adults, smoking carries a higher risk of occurrence and aggravation of Crohn’s disease. An opposite effect appears in ulcerative colitis.
Aim: To analyse selected parameters of the clinical course of Crohn’s disease in children and adolescents in view of exposure to cigarette smoke.
Material and methods: 48 patients aged 4 to 18 with Crohn’s disease were qualified for the test. Exposure to cigarette smoke was assessed by determination of nicotine metabolite (cotinine) in the patients’ urine. Two groups of subjects were distinguished: group I – patients with Crohn’s disease with a positive result; group II – patients with Crohn’s disease with a negative result.
Results: There is no significant difference in activity of the disease, hospitalizations, the frequency of steroid therapy and immunosuppression between the two groups of patients. Statistically longer time from the moment of the first symptoms to diagnosis and older age at the moment of diagnosis in patients with Crohn’s disease exposed to tobacco smoke were found.
Conclusions: On the basis of the examinations and statistical analysis it was concluded that exposure to cigarette smoke among paediatric patients with Crohn’s disease may hinder and retard the time of making a diagnosis and, therefore, implementation of adequate treatment. It seems that tobacco smoke exposure does not influence the incidence of aggravation and disease activity or the incidence of steroid therapy and necessity of immunosuppression in children and adolescents with Crohn’s disease.