Incidence and Risk Factors for Perianal Disease in Pediatric Crohn Disease Patients Followed in CEDATA-GPGE Registry.

Autor: Brückner A; Division of Pediatric Gastroenterology, Dr. von Hauner Children's Hospital, Ludwig Maximilians University, Munich., Werkstetter KJ; Division of Pediatric Gastroenterology, Dr. von Hauner Children's Hospital, Ludwig Maximilians University, Munich., de Laffolie J; Department of Pediatrics, University Hospital Gießen and Marburg, Justus-Liebig-University, Gießen, Germany., Wendt C; Department of Pediatrics, University Hospital Gießen and Marburg, Justus-Liebig-University, Gießen, Germany., Prell C; Division of Pediatric Gastroenterology, Dr. von Hauner Children's Hospital, Ludwig Maximilians University, Munich., Weidenhausen T; Department of Pediatrics, University Hospital Gießen and Marburg, Justus-Liebig-University, Gießen, Germany., Zimmer KP; Department of Pediatrics, University Hospital Gießen and Marburg, Justus-Liebig-University, Gießen, Germany., Koletzko S; Division of Pediatric Gastroenterology, Dr. von Hauner Children's Hospital, Ludwig Maximilians University, Munich.
Jazyk: angličtina
Zdroj: Journal of pediatric gastroenterology and nutrition [J Pediatr Gastroenterol Nutr] 2018 Jan; Vol. 66 (1), pp. 73-78.
DOI: 10.1097/MPG.0000000000001649
Abstrakt: Objectives: Perianal disease (PD) with fistula and/or abscess formation is a severe complication in Crohn disease (CD). We examined prevalence, incidence, and risk factors for PD development in a pediatric CD cohort.
Methods: Patients with CD from the prospective, multicenter registry for inflammatory bowel disease from Germany and Austria (CEDATA-GPGE) were included if diagnosed at the age of 18 years or younger, registered within 3 months after diagnosis, and having at least 2 follow-up visits within the first year of registration. We examined potential risk factors for PD with Kaplan-Meier analysis and a final Cox model considering sex, family history of inflammatory bowel disease, extraintestinal manifestations, disease location, and induction therapy (corticosteroids or nutritional therapy).
Results: Of 2406 patients with CD, 742 fulfilled inclusion criteria (59% boys, mean age at diagnosis 12.4 ± 3.4 years). PD was present at diagnosis in 41 patients (5.5%; 80.9% boys), whereas 32 patients (4.3%, 81.3% male) developed PD during follow-up (mean 2.0 ± 1.6 years). The cumulative incidence of PD at 12 and 36 months after diagnosis was 3.5% and 7.5%, respectively. Potential risk factors for PD development during follow-up were male sex (hazard ratio = 3.2, [95%; confidence interval 1.2-7.8]) and induction therapy with corticosteroids (hazard ratio = 2.5 [1.1-5.5]). Diagnostic evaluation at PD diagnosis was incomplete in 40% of affected subjects. PD resolved within 1 year in 50% of cases.
Conclusions: Approximately 10% of CD patients in our cohort suffered from PD within the first 3 years of their disease. Male sex and initial corticosteroid therapy were associated with an increased risk to develop PD after diagnosis.
Databáze: MEDLINE
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