Outcome of childhood ulcerative colitis at 2 years

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To cite this article: LJ Howarth, AE Wiskin, DM Griffiths, NA Afzal, RM Beattie Outcome of childhood ulcerative colitis at 2 years Acta Paediatrica (OnlineEarly Articles). doi:10.1111/j.1651-2227.2007.00515.x

REGULAR ARTICLE

Outcome of childhood ulcerative colitis at 2 years

LJ Howarth11.Paediatric Medical Unit, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD, United Kingdom, AE Wiskin11.Paediatric Medical Unit, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD, United Kingdom, DM Griffiths22.Wessex Regional Centre for Paediatric Surgery, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD, United Kingdom, NA Afzal11.Paediatric Medical Unit, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD, United Kingdom, RM Beattie11.Paediatric Medical Unit, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD, United Kingdom

1.Paediatric Medical Unit, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD, United Kingdom 2.Wessex Regional Centre for Paediatric Surgery, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD, United Kingdom

CorrespondenceR. M. Beattie, Consultant Paediatric Gastroenterologist, Paediatric Medical Unit, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD, United Kingdom. Tel.: +44 1238079688 | Fax: +44 1238079688 | Email: Mark.beattie@...

Abstract Aim: Ulcerative Colitis (UC) has an incidence of 1.4 per 100 000 in childhood. There is a paucity of data regarding outcome particularly with the increased use of early immunosuppression. This study reviews outcome at 2 years in a cohort with UC referred to a single centre.

Method: Patients were recruited on the basis of a diagnosis made between 2000 and 2003 as a consecutive cohort. All had UC according to standard clinicopathological criteria. Children with indeterminate colitis were excluded. Follow-up data was collected at 2 years by case notes review.

Results: Thirty-two children are reported. The median age at diagnosis was 11 years (range 2–16). All were treated with corticosteroids and 5-ASA derivatives at diagnosis. The majority of patients (94%, 30/32) received more than one course of steroids. By 2 years azathioprine use was high with 75% (24/32) of patients on treatment for steroid-dependent disease. There were 6 extra-intestinal manifestations and 8 disease related complications occurring in 12 patients (38%). The colectomy rate was 9% (3/32) for unresponsive disease.

Conclusion: There is a high need for Azathioprine in childhood UC. Colectomy rate at 2 years was around 10%. Extra-intestinal manifestations and disease related complications are common.