Clinical Phenotypes and Outcomes in Monogenic Versus Non-monogenic Very Early Onset Inflammatory Bowel Disease

Autor: Lauren V, Collen, David Y, Kim, Michael, Field, Ibeawuchi, Okoroafor, Gwen, Saccocia, Sydney Driscoll, Whitcomb, Julia, Green, Michelle Dao, Dong, Jared, Barends, Bridget, Carey, Madison E, Weatherly, Shira, Rockowitz, Piotr, Sliz, Enju, Liu, Alal, Eran, Leslie, Grushkin-Lerner, Athos, Bousvaros, Aleixo M, Muise, Christoph, Klein, Vanessa, Mitsialis, Jodie, Ouahed, Scott B, Snapper
Rok vydání: 2021
Předmět:
Zdroj: J Crohns Colitis
ISSN: 1876-4479
Popis: Background and Aims Over 80 monogenic causes of very early onset inflammatory bowel disease [VEOIBD] have been identified. Prior reports of the natural history of VEOIBD have not considered monogenic disease status. The objective of this study is to describe clinical phenotypes and outcomes in a large single-centre cohort of patients with VEOIBD and universal access to whole exome sequencing [WES]. Methods Patients receiving IBD care at a single centre were prospectively enrolled in a longitudinal data repository starting in 2012. WES was offered with enrollment. Enrolled patients were filtered by age of diagnosis Results This analysis included 216 VEOIBD patients, followed for a median of 5.8 years. Seventeen patients [7.9%] had monogenic disease. Patients with monogenic IBD were younger at diagnosis and were more likely to have Crohn’s disease phenotype with higher rates of stricturing and penetrating disease and extraintestinal manifestations. Patients with monogenic disease were also more likely to experience outcomes of intensive care unit [ICU] hospitalisation, gastrostomy tube, total parenteral nutrition use, stunting at 3-year follow-up, haematopoietic stem cell transplant, and death. A total of 41 patients [19.0%] had infantile-onset disease. After controlling for monogenic disease, patients with infantile-onset IBD did not have increased risk for most severity outcomes. Conclusions Monogenic disease is an important driver of disease severity in VEOIBD. WES is a valuable tool in prognostication and management of VEOIBD.
Databáze: OpenAIRE