Phenotypic characteristics of childhood-onset IBD

The latest issue of Gastroenterology defines phenotypic characteristics of childhood-onset in IBD.

Childhood-onset inflammatory bowel disease (IBD) might be etiologically different from adult-onset inflammatory bowel disease.

Dr Johan Van Limbergen and colleagues from the United Kingdom analyzed disease phenotypes and progression of childhood-onset disease and compared them with characteristics of adult-onset disease in patients in Scotland.

The team assessed anatomic locations and behaviours in 416 patients with childhood-onset, and 1297 patients with adult-onset inflammatory bowel disease using the Montreal classification.

At the time of diagnosis in children, Crohn's disease involved small bowel and colon in 51%, colon in 36%, and ileum in 6%.

The upper gastrointestinal tract was also affected in 51%.

24% of children developed stricturing complications within 4 years

Gastroenterology

In 39%, the anatomic extent increased within 2 years.

The team found that 24% of children developed stricturing or penetrating complications within 4 years.

The team noted that, compared with adults, childhood-onset disease was characterized by a “panenteric” phenotype, with less isolated ileal or colonic disease.

Ulcerative colitis was extensive in 82% of the children at diagnosis, versus 48% of adults.

The research team observed that 46% of the children progressed to develop extensive colitis during follow-up.

The team noted that 46% of children with Crohn's disease, and 35% with ulcerative colitis required immunomodulatory therapy within 12 months of diagnosis.

The median time to first surgery was longer in childhood-onset than adult-onset patients with Crohn's disease.

The researchers found that the reverse was true for ulcerative colitis.

Dr Van Limbergen’s team concluded, “Childhood-onset inflammatory bowel disease is characterized by extensive intestinal involvement and rapid early progression.”