Comparison of clinical features between very earl-onset inflammatory bowel diseases and late-onset inflammatory bowel diseases

Abstract

Objective To summarize the clinical data of the children with inflammatory bowel diseases(IBD), including Crohn′s disease (CD) and ulcerative colitis (UC), and to analyze and compare the clinical features of very early-onset IBD (VEO-IBD) and late-onset IBD (LO-IBD). Methods A retrospective analysis of the clinical data of 184 cases of IBD hospitalized children diagnosed at Beijing Children′s Hospital, Capital Medical University from January 2000 to December 2014.According to their ages of onset, the patients were divided into VEO-IBD group (<6 years old) and LO-IBD group (6-16 years old); the patients with CD were divided into VEO-CD group (<6 years old) and LO-CD group (6-16 years old); UC were divided into VEO-UC group (<6 years old) and LO-UC group (6-16 years old). The clinical features among each group were analyzed and compared. Results A total of 184 IBD patients were included in the study, 77 cases(41.8%) were VEO-IBD and 107 cases(58.2%) were LO-IBD.Comparison between VEO-CD group and LO-CD group indicated that abdominal pain was more common in LO-CD group(P<0.05), while diarrhea and hematochezia were more common in VEO-CD group(all P<0.05). In addition, comparison between VEO-UC group and LO-UC group indicated that abdominal pain was more common in LO-UC group(P<0.001), while diarrhea, fever, and oral ulcers were more common in VEO-UC group (all P<0.05). Both VEO-CD and LO-CD group were mainly ileocolonic[15/27 cases (55.6%), 20/47 cases (42.6%)], non-narrow, non-penetrating [20/27 cases (74.1%), 30/47 cases (63.8%)] and moderate-to-severe activity[23/27 cases(85.2%), 37/47 cases (78.7%)]. The incidence of perianal lesions in the VEO-CD group was as high as 51.9% (14/27 cases), which was significantly higher than that in the LO-CD group (9/47 cases, 19.1%) (P<0.05). Left-sided UC and severe UC were more common in VEO-UC group(all P<0.05), while pancolitis and mild UC were more common in LO-UC group (all P<0.05). The incidence of intestinal perforation in the VEO-UC group was significantly higher than that in the LO-UC group (P<0.05). The incidence of surgical rate, intestinal obstruction, and intestinal perforation in the LO-CD group were significantly higher than those in the LO-UC group (all P<0.05). Conclusions Compared between VEO-IBD and LO-IBD, VEO-IBD patients are more severe, with perianal lesions more common, and the incidence of intestinal perforation is higher. Key words: Inflammatory bowel disease, very early-onset; Crohn′s disease; Colitis, ulcerative; Child