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 20 February 2018

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News

The natural history of Crohn’s disease in children

A study in the most recent issue of the European Journal of Gastroenterology & Hepatology reviews the natural history of Crohn’s disease in children.

News image

The incidence of Crohn’s disease has been reported to increase.

Dr Dana Duricova and colleagues performed a comprehensive literature search of population-based studies focused on the natural history of pediatric-onset Crohn’s disease.

The researchers performed a literature search of English and non-English language publications listed in the electronic database of MEDLINE, and EMBASE from 1935 to 2016.

Population-based studies or national cohorts reporting data on the short-term or long-term disease course of pediatric Crohn’s disease were included.

The research team identified 49 pediatric, and 15 nonpediatric studies on Crohn’s disease.

About 33% of children with inflammatory behavior developed bowel complications more than 5 years after diagnosis.

More than 33% of children have received biological treatment early in the disease course
European Journal of Gastroenterology & Hepatology

The team observed that from 48% to 88% of children have experienced at least one corticosteroid course irrespective of the period of diagnosis, and up to 33% became steroid dependent.

The researchers found that immunosuppressive preparations were used earlier, and more frequently in newer than older cohorts.

The team noted that more than 33% of children have received biological treatment early in the disease course.

A decline in the surgery rate might be observed in more recent compared with older unselected populations.

The team found that the relative risk of cancer in childhood-onset Crohn’s disease as well as the risk of death seem to have increased.

Dr Duricova's team concludes, "Childhood-onset Crohn’s disease seems to be an aggressive phenotype of the disease."

"Compared with older cohorts, a trend towards decreasing surgical rate can be observed in newer cohorts paralleled by an increase in immunomodulator use and biologicals."

"Nevertheless, the causative role has yet to be investigated."

Eur J Gastroenterol Hepatol 2017: 29(2): 125–134
17 January 2017

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