Abstract

BackgroundTo investigate the unique features of inflammatory bowel disease (IBD) in children, we wanted to identify whether there might be a strong correlation between the disease phenotype and its prognosis at various ages in paediatric patients.MethodsWe collected data from patients diagnosed with IBD (ulcerative colitis (UC) or Crohn’s disease (CD)) from 2002 to 2016. The diagnosis was made according to the Porto criteria and Paris Classification. Patient characteristics, clinical manifestations and treatments were collected. Risk factors for surgery, mortality and relapse were analysed by Cox proportional hazard models.ResultsOf the 143 patients, 113 had CD, and 30 had UC; there were 89 males and 54 females with a median age of 9 years (y). Thirteen patients in the 0–2 y group were identified as having mutations in IL-10 receptor A, and this mutation was significantly more common in this age group than in 3–9 and 10–16 y patients. The risk factor for surgery was the B3 phenotype; risk factors for death were age 0–2 y and B3 phenotype; 0–2 y, B3 phenotype and steroid dependency were risk factors for early relapse.ConclusionsClinical manifestations of the onset of IBD in infants and toddlers were extensive and aggressive and were closely associated with early relapse and death. It is of particular interest that some of these patients developed IBD due to monogenic disorders; thus, introduction of genetic testing is essential for these patients.

Highlights

  • To investigate the unique features of inflammatory bowel disease (IBD) in children, we wanted to identify whether there might be a strong correlation between the disease phenotype and its prognosis at various ages in paediatric patients

  • We focused on the children with very early onset IBD (VEO-IBD), including infantile and toddler onset IBD, as infantile IBD might be partially linked to monogenic diseases such as defects in IL-10 or its receptors, Wiskott-Aldrich Syndrome, XIAP deficiency, leukocyte adhesion deficiencies, CD40L deficiency, IPEX syndrome and several others [7,8,9]

  • Because the clinical manifestations and phenotypes vary in IBD children, the prognosis of IBD is remarkably different in patients of different ages, and there is a lack of long-term follow-up studies on the natural course of the disease

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Summary

Introduction

To investigate the unique features of inflammatory bowel disease (IBD) in children, we wanted to identify whether there might be a strong correlation between the disease phenotype and its prognosis at various ages in paediatric patients. Our previous studies have indicated that the morbidity of paediatric IBD has been rapidly increasing in China over the past three decades [2]. Studies have shown that paediatric IBD manifests as an extensive and aggressive. Because the clinical manifestations and phenotypes vary in IBD children, the prognosis of IBD is remarkably different in patients of different ages, and there is a lack of long-term follow-up studies on the natural course of the disease.

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