Demographic characteristics of children with early clinical manifestation of inflammatory bowel disease

Abstract

IntroductionInflammatory bowel disease (IBD), which includes Crohn's disease (CD) and ulcerative colitis (UC), is a chronic condition of the colon and small intestine. The disease is common in young people (children and young adults), but it is rare in children younger than five years of age. Therefore, IBD developing during the first years of life (under the age of 5) is known as an early-onset IBD (EO-IBD), and it is considered to be a specific entity with a distinct phenotype. However, the available data on that issue are still insufficient.AimTo determine the characteristics and clinical course of children with early-onset IBD.Material and methodsWe performed a retrospective database analysis of 47 infants younger than 5 years old diagnosed with IBD. Patient's demographic data, including age, sex, and age at disease onset, were collected in 6 paediatric hospitals in Poland. Disease location was established on the basis of the review of all endoscopic, colonoscopic, histopathological, and radiological records. All possible complications were reported, as well as any treatment and its efficacy. Since the diagnosis was established all patients have been on follow up.ResultsAmong 47 children registered in the database, 23 (49%) had a diagnosis of CD, 16 (34%) had UC, and 8 (17%) had IC (indeterminate colitis). The mean age at diagnosis was 28.5 ±27.5 months; 57.4% were male. The most common location/type of disease was ileocolonic disease (L3). The most common complication of IBD was anaemia, found in 30 (63.8%) children. The observed course of the disease was either severe or moderate. In 4 children younger than 2 years old, surgery was performed.ConclusionsInflammatory bowel disease in children younger than 5 years old includes UC, CD, and a relatively high proportion of IC. In early-onset IBD severe and moderate course of the disease is usually observed. Disease manifestation in these patients is predominantly ileocolonic.

Special clinical characteristics and outcomes in Chinese pediatric patients with early‐onset Crohn's disease

“…Our study found that those with EO‐CD had lower height and weight percentiles than patients with LO‐CD at the time of diagnosis and at each follow‐up visit. In prior studies, the most common complication of IBD was anemia . In our study, patients with EO‐CD also had lower levels of hemoglobin, albumin, zinc and rion at diagnosis than those with LO‐CD.…”

Very early‐onset inflammatory bowel disease in Japan: A nationwide survey

“…Previous studies have reported that VEO‐IBD cases have more colonic and perianal involvement, especially in pediatric Crohn's disease 3,6–9 . In this study, all but one patient underwent colonoscopy.…”

“…Younger IBD patients, especially those with VEO‐IBD, are known to carry higher genetic components in their disease etiology 8,9,12,13 . A genetic diagnosis is particularly important because some monogenic IBD cases have been reported as curable by hematopoietic stem cell transplantation 2,14,15 .…”

“…Previous studies have reported that VEO-IBD cases have more colonic and perianal involvement, especially in pediatric Crohn's disease. 3,[6][7][8][9] In this study, all but one patient underwent colonoscopy. Esophagogastroduodenoscopy was performed for approximately two-thirds of patients.…”

The Role of Familial Mediterranean Fever Gene Mutation in Treatment of Infantile Colitis With Resistant Perianal Fistula

“…Environmental factors and genetic predisposition may also play a role in I-IBD. 2 The presence of specific mutations affecting the interleukin-10 (IL-10) receptor and Mediterranean fever (MEFV) gene seems to play a fundamental role in I-IBD. 3,4 Previous reports described the response of I-IBD patients with familial Mediterranean fever (FMF) to colchicine therapy.…”