Early-onset pediatric inflammatory bowel diseases (IBD) seem to be more extensive than those with a later onset.
To test this hypothesis, Dr Marina Aloi and colleagues 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.
Anatomic locations and behaviors were assessed according to Paris classification in 506 consecutive patients, involving 224 Crohn's disease, 245 ulcerative colitis, and 37 IBD-unclassified.
The researchers found that 11% of patients were in the range 0 to 5 years, 39% in 6 to 11 years, and 50% in 12 to 18 years.
|62% of the patients in the 0 to 5 years range had pancolonic ulcerative colitis|
|Inflammatory Bowel Disease|
The team found that ulcerative colitis was the most frequent diagnosis in early-onset-IBD, and in 6- to 11-year-old group, whereas Crohn's disease was predominant in older children.
A classification as IBD-unclassified was more common in the range 0 to 5 years compared with the other groups.
Early-onset Crohn's disease showed a more frequent isolated colonic, and upper gastrointestinal involvement than later-onset disease.
The team noted that 62% of the patients in the 0 to 5 years range had pancolonic ulcerative colitis, compared with 38% of 6 to 11 years, and 31% of 12–18 years 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.
The researchers observed that surgical risk did not differ according to age.
Dr Aloi's team comments, "Early-onset-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 early-onset disease."