Incidence of stricturing and penetrating complications of Crohnʼs disease diagnosed in pediatric patients

Abstract

Background The development of disease complications is poorly characterized in pediatric patients with Crohn’s disease (CD). Methods We retrospectively determined the cumulative incidence of stricturing and penetrating complications of CD prior to first surgery utilizing data from 989 consecutively enrolled CD patients (age 0–17 years at diagnosis) collected between January 2000 and November 2003 and stored in the Pediatric IBD Consortium Registry. Results Mean age at diagnosis was 11.5 ± 3.8 (standard deviation) years. Median follow-up time was 2.8 years. Prior to first surgery, the cumulative incidence of stricturing or penetrating complications was 27% at 5 years and 38% at 10 years from the diagnosis of inflammatory bowel disease. The cumulative incidence of complicated disease was lowest in isolated colonic disease (P = 0.009). Penetrating complications that followed stricturing complications prior to first surgery occurred within 2 years of stricturing complications (cumulative incidence was 13% at 2 years from diagnosis of stricturing disease). Stricturing complications that followed penetrating complications prior to first surgery occurred within 8 years of penetrating complications (cumulative incidence was 26% at 8 years from diagnosis of penetrating complications). Conclusions Strictures, abscesses, and fistulas are common in pediatric CD. Earlier aggressive management may be indicated. Prospective study is required to identify genetic and serologic markers that predict a patient’s risk for the development of complicated disease and to determine optimal treatment regimens.

Eosinophils and IL-33 Perpetuate Chronic Inflammation and Fibrosis in a Pediatric Population with Stricturing Crohnʼs Ileitis

“…(1) In fact, the cumulative incidence of stricturing disease has been reported as 27% at 5 years and 38% at 10 years. (2) Although certain similarities exist between pediatric and adult onset disease, pediatric disease is distinct, with more extensive and rapidly progressing pathology. (3) Thus studies focusing specifically on pediatric patients are of great value to gain a better understanding of cause and improved treatments or preventions.…”

DNA methylation-associated colonic mucosal immune and defense responses in treatment-naïve pediatric ulcerative colitis

“…IBD incidence is the highest in young adulthood. Remarkably, IBDs are becoming more common, especially in the pediatric population 3 - 5 . The increased number of pediatric cases appear to result from an overall amplified incidence rather than a shift toward disease onset at younger age 6 .…”

Magnetic resonance enterography findings of a gastrocolic fistula in Crohn’s disease

“…According to the Montreal classification of inflammatory bowel disease, three patterns of CD are distinguished; non-stricturing/non-penetrating disease, stricturing (stenotic or obstructive) disease, and penetrating (fistulous, with inflammatory masses and/or abscesses) disease (1). Although this classification suggests that patients have a tendency to progress toward either structuring or penetrating disease, both disease patterns can coexist as in our case (2). MRE can help to establish the presence of these different CD phenotypes.…”