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

Szymańska E, Szymańska S, Szczepański M, Landowski P, Czaja-Bulsa G, Jarocka-Cyrta E, Korczowski B, Krzesiek E, Kierkuś J - Prz Gastroenterol (2015)

Bottom Line: The most common complication of IBD was anaemia, found in 30 (63.8%) children.In early-onset IBD severe and moderate course of the disease is usually observed.Disease manifestation in these patients is predominantly ileocolonic.

View Article: PubMed Central - PubMed

Affiliation: Department of Paediatrics, Nutrition, and Metabolic disorders, Children's Memorial Health Institute, Warsaw, Poland.

ABSTRACT

Introduction: Inflammatory 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.

Aim: To determine the characteristics and clinical course of children with early-onset IBD.

Material and methods: We 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.

Results: Among 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.

Conclusions: Inflammatory 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.

No MeSH data available.


Related in: MedlinePlus

Location of the disease according to Montreal Classification
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Figure 0001: Location of the disease according to Montreal Classification

Mentions: Among 47 children registered in the database 23 (49%) had a diagnosis of CD, 16 (34%) had UC, and 8 (17%) had IC. The mean age at diagnosis was 28.5 ±27.5 months; 57.4% were male. One (2.12%) patient had limited caecal disease (L1), 20 (42.5%) had colon involvement (L2), and 25 (53.2%) had ileocolonic location (L3), whether CD, UC, or IC. Upper gastrointestinal tract involvement was found in seven CD patients, but it was not isolated upper disease (L4) as they had simultaneously either colonic or ileocolonic lesions. In 1 (2.15%) UC patient extra-intestinal manifestation of the disease was a presenting symptom. In this case the diagnosis of IBD was established on the base of a histopathological examination of the biopsy taken during endoscopy performed as part of a differential diagnosis. Table I presents demographic characteristic of 47 patients with EO-IBD, and Figure 1 presents the exact location of the disease in CD, UC, and IC patients individually. Anaemia, the most common complication, was detected in 30 (63.8%) objects. Three (6.4%) patients younger than 3 years of age developed strictures; 2 (4.2%) patients younger than 1 year of age developed abscess; 1 (4.2%) patient at the age of 4 months developed fistula. Most children were treated with mesalamine (93.6%) and/or steroids (59.6%) either orally or intravenously. Five CD patients younger than 3 years of age were administered infliximab and 4 of them had to undergo surgery. Figure 2 presents the types and incidences of administered treatments. Overall, response to the treatment was positive in most cases; the average number of flare-ups was one, except from 4 of the CD patients who were treated with therapy including biological agents and operation.


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

Szymańska E, Szymańska S, Szczepański M, Landowski P, Czaja-Bulsa G, Jarocka-Cyrta E, Korczowski B, Krzesiek E, Kierkuś J - Prz Gastroenterol (2015)

Location of the disease according to Montreal Classification
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4814533&req=5

Figure 0001: Location of the disease according to Montreal Classification
Mentions: Among 47 children registered in the database 23 (49%) had a diagnosis of CD, 16 (34%) had UC, and 8 (17%) had IC. The mean age at diagnosis was 28.5 ±27.5 months; 57.4% were male. One (2.12%) patient had limited caecal disease (L1), 20 (42.5%) had colon involvement (L2), and 25 (53.2%) had ileocolonic location (L3), whether CD, UC, or IC. Upper gastrointestinal tract involvement was found in seven CD patients, but it was not isolated upper disease (L4) as they had simultaneously either colonic or ileocolonic lesions. In 1 (2.15%) UC patient extra-intestinal manifestation of the disease was a presenting symptom. In this case the diagnosis of IBD was established on the base of a histopathological examination of the biopsy taken during endoscopy performed as part of a differential diagnosis. Table I presents demographic characteristic of 47 patients with EO-IBD, and Figure 1 presents the exact location of the disease in CD, UC, and IC patients individually. Anaemia, the most common complication, was detected in 30 (63.8%) objects. Three (6.4%) patients younger than 3 years of age developed strictures; 2 (4.2%) patients younger than 1 year of age developed abscess; 1 (4.2%) patient at the age of 4 months developed fistula. Most children were treated with mesalamine (93.6%) and/or steroids (59.6%) either orally or intravenously. Five CD patients younger than 3 years of age were administered infliximab and 4 of them had to undergo surgery. Figure 2 presents the types and incidences of administered treatments. Overall, response to the treatment was positive in most cases; the average number of flare-ups was one, except from 4 of the CD patients who were treated with therapy including biological agents and operation.

Bottom Line: The most common complication of IBD was anaemia, found in 30 (63.8%) children.In early-onset IBD severe and moderate course of the disease is usually observed.Disease manifestation in these patients is predominantly ileocolonic.

View Article: PubMed Central - PubMed

Affiliation: Department of Paediatrics, Nutrition, and Metabolic disorders, Children's Memorial Health Institute, Warsaw, Poland.

ABSTRACT

Introduction: Inflammatory 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.

Aim: To determine the characteristics and clinical course of children with early-onset IBD.

Material and methods: We 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.

Results: Among 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.

Conclusions: Inflammatory 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.

No MeSH data available.


Related in: MedlinePlus