Format

Send to

Choose Destination
J Crohns Colitis. 2017 May 1;11(5):519-526. doi: 10.1093/ecco-jcc/jjw194.

Incidence and Phenotype at Diagnosis of Very-early-onset Compared with Later-onset Paediatric Inflammatory Bowel Disease: A Population-based Study [1988-2011].

Author information

1
Division of Gastroenterology, Hepatology and Nutrition, Department of Paediatrics, Lille University Jeanne de Flandre Children's Hospital, University of Lille, Lille, France.
2
Public Health, Epidemiology and Economic Health, Registre EPIMAD, Maison Régionale de la Recherche Clinique, Lille University and Hospital, Lille, France.
3
Lille Inflammation Research International Center LIRIC - UMR 995 Inserm Lille 2 University, CHRU de Lille, Lille, France.
4
Gastroenterology Unit, EPIMAD Registry, CHU Amiens Sud, Amiens University Hospital, Amiens, France.
5
Biostatistics Unit, EA 2694, Lille University and Hospital, Lille, France.
6
Gastroenterology Unit, EPIMAD Registry, Hôpital Charles Nicolle, Rouen University Hospital, Rouen, France.
7
Gastroenterology Unit, Hôpital Huriez, Lille University Hospital, Lille, France.
8
Paediatric Unit, St Vincent Hospital, Catholic University, Lille, France.
9
Gastroenterology Unit, Les Bonnettes Private Hospital, Arras, France.
10
Gastroenterology Unit, General Hospital, Seclin, France.
11
Gastroenterology Unit, Inserm U954, Université de Lorraine, Nancy, France.

Abstract

Background and Aims:

Very-early-onset inflammatory bowel disease [VEO-IBD] is a form of IBD that is distinct from that of children with an older onset. We compared changes over time in the incidence and phenotype at diagnosis between two groups according to age at IBD diagnosis: VEO-IBD diagnosed before the age of 6 years, and early-onset IBD [EO-IBD] diagnosed between 6 and 16 years of age.

Methods:

Data were obtained from a cohort enrolled in a prospective French population-based registry from 1988 to 2011.

Results:

Among the 1412 paediatric cases [< 17 years], 42 [3%] were VEO-IBD. In the VEO-IBD group, the incidence remained stable over the study period. In contrast, the incidence of EO-IBD increased from 4.4/105 in 1988-1990 to 9.5/105 in 2009-2011 [+116%; p < 10-4]. Crohn's disease [CD] was the most common IBD, regardless of age, but ulcerative colitis [UC] and unclassified IBD were more common in VEO-IBD cases [40% vs 26%; p = 0.04]. VEO-IBD diagnosis was most often performed in hospital [69% vs 43%; p < 10-3]. Rectal bleeding and mucous stools were more common in patients with VEO-IBD, whereas weight loss and abdominal pain were more frequent in those with EO-IBD. Regarding CD, isolated colonic disease was more common in the VEO-IBD group [39% vs 14%; p = 0.003].

Conclusions:

In this large population-based cohort, the incidence of VEO-IBD was low and stable from 1988 to 2011, with a specific clinical presentation. These results suggest a probable genetic origin for VEO-IBD, whereas the increase in EO-IBD might be linked to environmental factors.

KEYWORDS:

Inflammatory bowel disease; clinical presentation; incidence; paediatric; very-early-onset

PMID:
28453757
DOI:
10.1093/ecco-jcc/jjw194
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Silverchair Information Systems
Loading ...
Support Center