Long-term follow-up data on Crohn’s disease diagnosed before 20 years of age is limited.
Dr Freeman and colleagues assessed the mortality, intestinal malignancy and need for resection in 224 patients with early-onset disease (96 males, 42.9%; 128 females, 57.1%).
The mean length of time that the participants were followed-up for was 12.2 years, with more than 50% of patients seen for over 10 years (almost 10% for over 25 years).
Most patients were diagnosed from ages 13 to 19 years, rather than in childhood.
The researchers found that ileocolonic disease was most common (128 of 224; 57.1%), while upper tract involvement (42 of 224; 18.8%) was frequent.
In addition, the research group noted that complex disease with strictures (28.6%) or penetrating complications (46.4%) was common.
|Mean time from diagnosis to first resection was 4.2 years|
|Canadian Journal of Gastroenterology|
To date, the researchers report 1 patient with early-onset disease as having died from a drug overdose and 1 as having developed rectal cancer.
The researchers have not reported any cases of epithelial dysplasia in endoscopic biopsies or resected intestine.
The researchers noted that 1 or more intestinal resections were required in 126 patients (56.3%; 58 males and 68 females).
More than 1 resection was needed in 52 patients (23.2%).
The mean time from diagnosis to first resection was 4.2 years and from first to second resection was 6.6 years, with most resections required in the first two years.
Dr Freeman commented, "Most patients who needed one or more resections had ileocolonic disease and had complex stricturing or penetrating disease."
"Information on long-term follow-up of early-onset Crohn’s disease is crucial to avoid the direct extrapolation of adult data to children and adolescents."