Clinical variables and disease course of pediatric ulcerative colitis (UC) have been poorly reported. The aim of this study was to retrospectively describe the phenotype and disease course of pediatric onset UC diagnosed at a tertiary referral Center for Pediatric Gastroenterology. PATIENTS AND METHODS: 110 patients with a diagnosis of UC were identified at our Department database. Records were reviewed for disease location and behavior at the diagnosis, family history for inflammatory bowel disease, pattern changes at the follow-up, need of surgery and cumulative risk for colectomy. RESULTS: Thirty-five % of patients had an early-onset disease (0-7years). At the diagnosis, 29% had proctitis, 22% left-sided colitis, 15% extensive colitis and 34% pancolitis. Fifteen % presented with a rectal sparing, while a patchy colonic inflammation was reported in 18%. Rectal sparing was significantly related to the younger age (p: <0.05). Disease extension at the follow up was reported in 29% of pts. No clinical variables at the diagnosis were related to the subsequent extension of the disease. The cumulative rates of colectomy were 9% at 2year and 14% at 5years. An extensive disease as well as acute severe colitis and corticosteroid therapy at the diagnosis were significantly associated with an increased risk of colectomy. CONCLUSIONS: Pediatric UC is extensive and severe at the diagnosis, with an overall high rate of disease extension at the follow-up. Endoscopic atypical features are common in young children. The colectomy rate is related to the location and severity of the disease at the diagnosis.

Disease course and efficacy of medical therapy in stricturing paediatric Crohn's disease / Aloi, Marina; Viola, Franca; DI NARDO, Giovanni; Civitelli, Fortunata; Oliva, Salvatore; Nuti, FEDERICA LILIA NICOLETTA MARIA; Cucchiara, Salvatore; D'Arcangelo, Giulia; Casciani, Emanuele; Dilillo, ANNA RACHELE SERENA. - In: DIGESTIVE AND LIVER DISEASE. - ISSN 1590-8658. - STAMPA. - 45:6(2013), pp. 464-468. [10.1016/j.dld.2013.01.020]

Disease course and efficacy of medical therapy in stricturing paediatric Crohn's disease

ALOI, MARINA;VIOLA, Franca;DI NARDO, Giovanni;CIVITELLI, FORTUNATA;OLIVA, SALVATORE;NUTI, FEDERICA LILIA NICOLETTA MARIA;CUCCHIARA, Salvatore;D'ARCANGELO, GIULIA;CASCIANI, EMANUELE;DILILLO, ANNA RACHELE SERENA
2013

Abstract

Clinical variables and disease course of pediatric ulcerative colitis (UC) have been poorly reported. The aim of this study was to retrospectively describe the phenotype and disease course of pediatric onset UC diagnosed at a tertiary referral Center for Pediatric Gastroenterology. PATIENTS AND METHODS: 110 patients with a diagnosis of UC were identified at our Department database. Records were reviewed for disease location and behavior at the diagnosis, family history for inflammatory bowel disease, pattern changes at the follow-up, need of surgery and cumulative risk for colectomy. RESULTS: Thirty-five % of patients had an early-onset disease (0-7years). At the diagnosis, 29% had proctitis, 22% left-sided colitis, 15% extensive colitis and 34% pancolitis. Fifteen % presented with a rectal sparing, while a patchy colonic inflammation was reported in 18%. Rectal sparing was significantly related to the younger age (p: <0.05). Disease extension at the follow up was reported in 29% of pts. No clinical variables at the diagnosis were related to the subsequent extension of the disease. The cumulative rates of colectomy were 9% at 2year and 14% at 5years. An extensive disease as well as acute severe colitis and corticosteroid therapy at the diagnosis were significantly associated with an increased risk of colectomy. CONCLUSIONS: Pediatric UC is extensive and severe at the diagnosis, with an overall high rate of disease extension at the follow-up. Endoscopic atypical features are common in young children. The colectomy rate is related to the location and severity of the disease at the diagnosis.
2013
Children; Crohn's disease; Medical therapy; Megnetic resonance imaging; Strictures; Adolescent; Adult; Child; Cohort Studies; Constriction, Pathologic; Crohn Disease; Digestive System Surgical Procedures; Female; Follow-Up Studies; Glucocorticoids; Humans; Intestinal Diseases; Longitudinal Studies; Magnetic Resonance Imaging; Male; Retrospective Studies; Severity of Illness Index; Treatment Outcome; Young Adult; Gastroenterology; Hepatology
01 Pubblicazione su rivista::01a Articolo in rivista
Disease course and efficacy of medical therapy in stricturing paediatric Crohn's disease / Aloi, Marina; Viola, Franca; DI NARDO, Giovanni; Civitelli, Fortunata; Oliva, Salvatore; Nuti, FEDERICA LILIA NICOLETTA MARIA; Cucchiara, Salvatore; D'Arcangelo, Giulia; Casciani, Emanuele; Dilillo, ANNA RACHELE SERENA. - In: DIGESTIVE AND LIVER DISEASE. - ISSN 1590-8658. - STAMPA. - 45:6(2013), pp. 464-468. [10.1016/j.dld.2013.01.020]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/516730
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