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 6 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 6 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 dise

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. Copyright © 2014 Crohn's & Colitis Foundation of America, Inc.

Phenotype and disease course of early-onset pediatric inflammatory bowel disease / Aloi, Marina; Paolo, Lionetti; Arrigo, Barabino; Graziella, Guariso; Stefano, Costa; Massimo, Fontana; Claudio, Romano; Giuliano, Lombardi; Erasmo, Miele; Patrizia, Alvisi; Paolo, Diaferia; Maurizio, Baldi; Vittorio, Romagnoli; Marco, Gasparetto; Monica Di, Paola; Monica, Muraca; Salvatore, Pellegrino; Cucchiara, Salvatore; Stefano, Martelossi. - In: INFLAMMATORY BOWEL DISEASES. - ISSN 1536-4844. - ELETTRONICO. - 20:4(2014), pp. 597-605. [10.1097/01.mib.0000442921.77945.09]

Phenotype and disease course of early-onset pediatric inflammatory bowel disease

ALOI, MARINA;CUCCHIARA, Salvatore;
2014

Abstract

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 6 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 6 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 dise
2014
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. Copyright © 2014 Crohn's & Colitis Foundation of America, Inc.
inflammatory bowel disease; early onset; children
01 Pubblicazione su rivista::01a Articolo in rivista
Phenotype and disease course of early-onset pediatric inflammatory bowel disease / Aloi, Marina; Paolo, Lionetti; Arrigo, Barabino; Graziella, Guariso; Stefano, Costa; Massimo, Fontana; Claudio, Romano; Giuliano, Lombardi; Erasmo, Miele; Patrizia, Alvisi; Paolo, Diaferia; Maurizio, Baldi; Vittorio, Romagnoli; Marco, Gasparetto; Monica Di, Paola; Monica, Muraca; Salvatore, Pellegrino; Cucchiara, Salvatore; Stefano, Martelossi. - In: INFLAMMATORY BOWEL DISEASES. - ISSN 1536-4844. - ELETTRONICO. - 20:4(2014), pp. 597-605. [10.1097/01.mib.0000442921.77945.09]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/554674
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