TY - JOUR
T1 - Phenotype and disease course of early-onset pediatric inflammatory bowel disease
AU - Aloi, Marina
AU - Lionetti, Paolo
AU - Barabino, Arrigo
AU - Guariso, Graziella
AU - Costa, Stefano
AU - Fontana, Massimo
AU - Romano, Claudio
AU - Lombardi, Giuliano
AU - Miele, Erasmo
AU - Alvisi, Patrizia
AU - Diaferia, Paolo
AU - Baldi, Maurizio
AU - Romagnoli, Vittorio
AU - Gasparetto, Marco
AU - Di Paola, Monica
AU - Muraca, Monica
AU - Pellegrino, Salvatore
AU - Cucchiara, Salvatore
AU - Martelossi, Stefano
PY - 2014
Y1 - 2014
N2 - Background: Early-onset (EO) pediatric inflammatory bowel diseases (IBD) seem to be more extensive than those with a later onset. To test this hypothesis, we examined the phenotype and disease course of patients with IBD diagnosis at 0 to 5 years, compared with the ranges ± to 11 and 12 to 18 years. Methods: Anatomic locations and behaviors were assessed according to Paris classification in 506 consecutive patients: 224 Crohn's disease, 245 ulcerative colitis, and 37 IBD-unclassified. Results: Eleven percent of patients were in the range 0 to 5 years, 39% in ± to 11 years, and 50% in 12 to 18 years. Ulcerative colitis was the most frequent diagnosis in EO-IBD and in 6- to 11-year-old group, whereas Crohn's disease was predominant in older children. A classification as IBDunclassified was more common in the range 0 to 5 years compared with the other groups (P <0.005). EO Crohn's disease showed a more frequent isolated colonic (P <0.005) and upper gastrointestinal involvement than later-onset disease. Sixty-two percent of the patients in the 0 to 5 years range had pancolonic ulcerative colitis, compared with 38% of ± to 11 years (P = 0.02) and 31% of 12-18 years (P = 0.002) range. No statistical difference for family history for IBD was found in the 3-year age groups. Therapies at the diagnosis were similar for all children. However, at latest follow-up, a significantly higher proportion of younger children were under steroids compared with older groups (P <0.05). Surgical risk did not differ according to age. Conclusions: EO-IBD exhibits an extensive phenotype and benefit from aggressive treatment strategies, although surgical risk is similar to later-onset disease. A family history for IBD is not common in EO disease.
AB - Background: Early-onset (EO) pediatric inflammatory bowel diseases (IBD) seem to be more extensive than those with a later onset. To test this hypothesis, we examined the phenotype and disease course of patients with IBD diagnosis at 0 to 5 years, compared with the ranges ± to 11 and 12 to 18 years. Methods: Anatomic locations and behaviors were assessed according to Paris classification in 506 consecutive patients: 224 Crohn's disease, 245 ulcerative colitis, and 37 IBD-unclassified. Results: Eleven percent of patients were in the range 0 to 5 years, 39% in ± to 11 years, and 50% in 12 to 18 years. Ulcerative colitis was the most frequent diagnosis in EO-IBD and in 6- to 11-year-old group, whereas Crohn's disease was predominant in older children. A classification as IBDunclassified was more common in the range 0 to 5 years compared with the other groups (P <0.005). EO Crohn's disease showed a more frequent isolated colonic (P <0.005) and upper gastrointestinal involvement than later-onset disease. Sixty-two percent of the patients in the 0 to 5 years range had pancolonic ulcerative colitis, compared with 38% of ± to 11 years (P = 0.02) and 31% of 12-18 years (P = 0.002) range. No statistical difference for family history for IBD was found in the 3-year age groups. Therapies at the diagnosis were similar for all children. However, at latest follow-up, a significantly higher proportion of younger children were under steroids compared with older groups (P <0.05). Surgical risk did not differ according to age. Conclusions: EO-IBD exhibits an extensive phenotype and benefit from aggressive treatment strategies, although surgical risk is similar to later-onset disease. A family history for IBD is not common in EO disease.
KW - Children
KW - Early onset
KW - Inflammatory bowel disease
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U2 - 10.1097/01.MIB.0000442921.77945.09
DO - 10.1097/01.MIB.0000442921.77945.09
M3 - Article
C2 - 24569242
AN - SCOPUS:84898724692
VL - 20
SP - 597
EP - 605
JO - Inflammatory Bowel Diseases
JF - Inflammatory Bowel Diseases
SN - 1078-0998
IS - 4
ER -