Infantile and Very Early Onset Inflammatory Bowel Disease: A Multicenter Study.
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| Title: | Infantile and Very Early Onset Inflammatory Bowel Disease: A Multicenter Study. |
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| Authors: | Guz-Mark, Anat, Aloi, Marina, Scarallo, Luca, Bramuzzo, Matteo, Escher, Johanna C., Alvisi, Patrizia, Henderson, Paul, Hojsak, Iva, Lev-Tzion, Raffi, El-Matary, Wael, Schwerd, Tobias, Granot, Maya, Sladek, l. Malgorzata, Strisciuglio, Caterina, Müller, Katalin E., Olbjørn, Christine, Tzivinikos, Christos, Yerushalmy-Feler, Anat, Huysentruyt, Koen, Norsa, Lorenzo |
| Source: | Pediatrics. Aug2024, Vol. 154 Issue 2, p1-10. 10p. |
| Subjects: | Inflammatory bowel disease diagnosis, Crohn's disease diagnosis, Ulcerative colitis diagnosis, Adrenocortical hormones, Symptoms, Treatment effectiveness, Retrospective studies, Descriptive statistics, Age factors in disease, Case studies, Patient aftercare, C-reactive protein, Colectomy, Genetic testing, Children |
| Abstract: | OBJECTIVES: This study described disease characteristics and long-term outcomes in patients diagnosed with very early onset inflammatory bowel disease (VEOIBD) (diagnosed before 6 years of age) and infantile-IBD (before 2 years). METHODS: Cases from 21 centers worldwide diagnosed with VEOIBD (2008-2018), with minimum 2 years of follow-up, were retrospectively reviewed. RESULTS: The cohort included 243 patients (52% males, median follow-up of 5.8 [range 2-18] years, including 69 [28%]) with infantile-IBD. IBD subtypes included Crohn's disease (CD), ulcerative colitis (UC), or IBD-unclassified (IBDU) in 30%, 59%, and 11%, respectively. Among patients with CD, 94% had colonic involvement, and among patients with UC/IBDU, 75% had pancolitis. Patients with infantile-IBD presented with higher rates of IBDU, lower hemoglobin and albumin levels, and higher C-reactive protein, and had lower response rates to first-induction therapy and corticosteroids therapy (P < .05 for all). Colectomy and diversion surgeries were performed in 11% and 4%, respectively, with no significant differences between age groups. Corticosteroid-free remission rates were 74% and 78% after 3 and 5 years, respectively, and 86% at end of follow-up. Genetic testing was performed in 96 (40%) patients. Among tested population, 15 (16%) were identified with monogenic disease. This group demonstrated lower response rates to induction therapies, higher rates of surgical intervention, and higher rates of major infections (P < .05 for all). CONCLUSIONS: Patients with VEOIBD, including infantile-IBD, exhibit low rate of complications and surgical interventions at the long term. Patients with monogenic IBD are at risk for more severe disease course. [ABSTRACT FROM AUTHOR] |
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| Database: | Psychology and Behavioral Sciences Collection |
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