Sammanfattning
Pediatric Crohn’s disease manifest with gastrointestinal symtoms as well as with growth reduction and delayed onset of puberty. Therapy with corticosteroids may worsen these effects, and ought therefore be reduced or replaced if possible. Yet early and effective treatment is necessary to provide healing of the intestinal mucosa, which is an important long term prognostic factor. Our summary of available published data shows that methotrexate (an immunomodulator) can induce remission, control disease activity and reduce corticosteroid exposure. Data indicates that methotrexate should be administered parenterally. Today methotrexate is used as a second line immunomodulator, after failed therapy with thiopurines. We argue for further studies to investigate if methotrexate could be used on an earlier step in the treatment of pediatric Crohn’s disease.