Abstract
To describe the clinical aspects observed in IBD children and adolescents under medical care at a gastroenterological reference center of a large public hospital in Brazil. Records of patients diagnosed as IBD from Jan/1976 to Sep/2006 were reviewed. Diagnosis were based on strict clinical, endoscopic, radiologic or surgical and histopathologic criteria. Clinical data of the patients were analysed as a whole and as 3 subgroups according to age of onset of symptoms. GI - 26 infants under 2 yrs, median 7.5mo±6mo (1-20mo); GII - 50 children between 2 and 10 yrs, median 4yrs11.5mo±2yrs1mo (2yrs-9yrs9mo) and GIII - 30 patients older than 10 years, median 11yrs4mo±1yr7mo (10-16yrs). 106 subjects, 60 male and 46 female, 41 Crohn's Disease (CD), 53 Ulcerative Colitis (UC) and 12 Indeterminate Colitis (IC) were included. Median age at onset of symptoms was 5yrs± 4yrs5mo (1mo-16yrs) and at diagnosis, 7yrs6mo± 4yrs6mo (4mo-17yrs). Median interval from onset of symptoms to diagnosis was 11mo± 2yrs8mo (1mo-12yrs11mo). 1 patient (UC) was diagnosed during 1976-1980 (P1); 12 (4 CD, 8 UC) during 1981-1990 (P2); 52 (24 CD, 19 UC, 9 IC) during 1991-2000 (P3) and 41 (13 CD, 25 UC, 3 IC) 2001-Sep/2006 (P4). Predominant manifestations were: bloody diarrhea (71.7%), abdominal pain (67.9%) and weight loss/growth retardation (48.1%). Other manifestations included fever (31.3%), vomiting (20.7%), anal/perineal lesions (17.3%), anorexia (15.1%), aphthous stomatitis (3.8%), joints, skin, and ocular manifestations (18%), liver diseases (18%) and tromboembolic diseases (0.9%). Median ages at diagnosis in GI, GII and GIII were respectively lyrs9mo±3yrslmo (4mo-13yrs3mo), 6yrs8mo±3yrs (2yrs10mo-15yrs2mo) and 12yrs3mo±3yrs(6mo-17yrs). CD (50%) predominated in GI while UC (60%) in GII. In GIII the distribution was the same for CD (46.7%) and UC (46.7%). IC was observed in 15.4% of the patients in GI, 12% in GII and 6.6% in GIII. In our Center, IBD is being more frequently diagnosed and UC is the predominant disease.
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