Children with early-onset inflammatory bowel disease (IBD): Analysis of a pediatric IBD consortium registry

[Guest guest]

doi:10.1016/j.jpeds.2004.08.043 Copyright © 2005 Elsevier Inc. All rights reserved.

Original Article

Children with early-onset inflammatory bowel disease (IBD): Analysis of a pediatric IBD consortium registry

Melvin B. Heyman MD, MPH, , Barbara S. Kirschner MD, D. Gold MD, Ferry MD, Baldassano MD, Stanley A. Cohen MD, Harland S. Winter MD, Fain BSN, RN, King RN, MSN, FNP, Terry MS and Hashem B. El-Serag MD, MPH From UCSF Children's Hospital, University of California, San Francisco; The University of Chicago Children's Hospital, Chicago, Illinois; Emory University School of Medicine, Atlanta, Georgia; Texas Children's Hospital, Baylor College of Medicine, Houston, Texas; Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Children's Center for Digestive Healthcare, Atlanta, Georgia; MassGeneral Hospital for Children, Boston, Massachusetts; and Gastroenterology and Health Services Research, Houston VA Medical Center, and Baylor College of Medicine, Houston, Texas Received 26 February 2004; revised 14 July 2004; accepted 17 August 2004. See editorial, p 7.. Available online 7 January 2005.

Referred to by:

A collaborative effort to define the epidemiology of pediatric inflammatory bowel disease: What can we learn from children with early-onset disease?The Journal of Pediatrics, Volume 146, Issue 1, January 2005, Pages 7-8M. Moyer

Objective

To determine the characteristics of inflammatory bowel disease (IBD) in young patients. Study design

Uniform data were collected from a cohort of patients with IBD who were enrolled from January 2000 to November 2002 at six pediatric centers (Pediatric IBD Consortium). Results

Of 1370 children in the registry, the mean age at IBD diagnosis was 10.3 ± 4.4 years; 54% were male, and 86% were white. Diagnosis was confirmed in 87 (6.1%) under 3 years of age, 211 (15.4%) before 6 years, 654 (47.7%) at 6 to 12 years, and 505 (36.9%) at 13 to 17 years. More than 63% of children younger than 8 years of age had isolated colonic disease, whether Crohn disease, ulcerative colitis (UC), or indeterminate colitis. Conversely, only 35% of those 8 years of age or older had isolated colonic disease (P < .0001). Overall, 29% had one or more family members with IBD. The subgroup of children younger than 3 years of age with UC had the highest prevalence of first-degree relatives with IBD (44%). Conclusions

This demographically diverse pediatric IBD cohort revealed age-related variation in the distribution of IBD phenotype, with a high prevalence of isolated colonic disease in young children. Positive family history was especially common in young patients with UC.

Abbreviations: CD, Crohn disease; IBD, Inflammatory bowel disease; IC, Indeterminate colitis; PediIBDC, Pediatric Inflammatory Bowel Disease Consortium; UC, Ulcerative colitis

Between April 2000 and March 2003, the Crohn's and Colitis Foundation of America (CCFA) was a major supporter of the consortium and supplemented development of the database. This support would not have been possible without the vision and commitment to pediatric IBD of Cutler. Investigators were also supported in part by grants from the NIH (DK060617 [MBH], DK053708 and DK062149 [bDG]), from the VA HSR & D CDA Awardee RCD00-013-2 [HES] and from The Cummings Foundation, Chicago, Illinois [bSK].Reprint requests: Dr Melvin B. Heyman, 500 Parnassus Ave, MU 4-East, Room 406, University of California, San Francisco, CA 94143-0136.

The Journal of Pediatrics Volume 146, Issue 1, January 2005, Pages 35-40