Phenotypic Variation in Paediatric Inflammatory Bowel Disease by Age: A Multicentre Prospective Inception Cohort Study of the Canadian Children IBD Network
| Autor: | Jennifer deBruyn, David R. Mack, Sally Lawrence, Wael El-Matary, Thomas D. Walters, Aleixo M. Muise, Colette Deslandres, Amanda Ricciuto, Eric I Benchimol, Jasbir Dhaliwal, Jeffrey Critch, Mohsin Rashid, Peter C Church, J Van Limbergen, Anthony R. Otley, Anne M. Griffiths, Kevan Jacobson, Prevost Jantchou, Kevin Bax, Eytan Wine, Hien Q. Huynh, Matthew W Carroll, Ernest G. Seidman, M E Sherlock |
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| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Canada phenotype IBD Disease Pediatrics Gastroenterology Inflammatory bowel disease Severity of Illness Index paediatrics Cohort Studies 03 medical and health sciences 0302 clinical medicine Crohn Disease Interquartile range Internal medicine medicine Humans Ileitis Prospective Studies Age of Onset Child business.industry Incidence (epidemiology) Incidence General Medicine Original Articles medicine.disease INCEPTION COHORT Ulcerative colitis digestive system diseases 3. Good health Biological Variation Population 030220 oncology & carcinogenesis Disease Progression 030211 gastroenterology & hepatology Colitis Ulcerative Female Age of onset business |
| Zdroj: | J Crohns Colitis Paediatrics Publications |
| Popis: | Background and AimsIncidence of paediatric inflammatory bowel disease [IBD] in Canada is among the highest worldwide, and age of onset may be decreasing. In a multicentre nationwide inception cohort study, we examined variation in phenotype of IBD throughout the paediatric age spectrum.MethodsChildren aged ≥2 years [y] and ResultsAmong 1092 children (70% Caucasian; 64% Crohn’s disease [CD], 36% ulcerative colitis/inflammatory bowel disease unclassified [UC/IBD-U]; median age 13 y, interquartile range [IQR] 11–15 y), 210 [19%] were diagnosed before the age of age 10 y [Paris A1a] and 43 [4%] before age 6 y (very-early-onset [VEO-IBD]). CD was less common in younger children [42%, 56%, 66%, respectively, of VEO-IBD, A1a; A1b]. Colon-only IBD [UC/IBDU or CD-colon] was present in 81% of VEO-IBD and 65% of A1a; ileal disease increased progressively, reaching plateau at age 10 y. CD location was ileocolonic [L3] in 53% overall. Ileitis [L1] increased with age [6% of VEO-IBD; 13% of A1a; 21% of A1b], as did stricturing/penetrating CD [4% of A1a; 11% of A1b]. At all ages UC was extensive [E3/E4] in >85%, and disease activity moderate to severe according to Physician’s Global Assessment [PGA] and weighted Paediatric Crohn’s Disease Activity Index/Paediatric Ulcerative Colitis Activity Index [wPCDAI/PUCAI] in >70%. Heights were modestly reduced in CD [mean height z score -0.30 ± 1.23], but normal in UC/IBD-U.ConclusionsParis classification of age at diagnosis is supported by age-related increases in ileal disease until age 10 years. Other phenotypic features, including severity, are similar across all ages. Linear growth is less impaired in CD than in historical cohorts, reflecting earlier diagnosis. |
| Databáze: | OpenAIRE |
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