Clinical—Alimentary TractDefinition of Phenotypic Characteristics of Childhood-Onset Inflammatory Bowel Disease
Section snippets
Subjects
We recruited 416 children with IBD diagnosed before their seventeenth birthday from all the pediatric gastroenterology centers in Scotland as part of an ongoing childhood-onset IBD genetics project from July 2002. Children were investigated according to the ESPGHAN “Porto”-criteria for diagnosis of IBD.13, 14 Detailed patient demographics are presented in Table 1. We also recruited 1297 patients with adult-onset IBD from the Gastroenterology Department at Western General Hospital, Edinburgh
CD at diagnosis
CD affected the small as well as large bowel (L3 ± L4) in 50.5%, the colon (L2 ± L4) in 36.3%, and the ileum (L1 ± L4) in 5.9%. More than half of children (50.9%) were affected by CD proximal to the terminal ileum at diagnosis (any L4). Follow-up of ≥2 years was completed for 196 of 273 patients (71.8%). Follow-up data of ≥4 years were available for 132 of 273 patients (48.4%; Table 3).
CD location
The location of disease changed over time. Detailed analysis of the 196 childhood-onset CD patients who had ≥2
Discussion
The present study represents not only a detailed application of the Montreal classification of IBD in a large cohort of patients with childhood-onset disease, but also provides new robust data on disease evolution, as well as need for immunomodulation and surgery in childhood-onset disease. Rigorous follow-up of 416 children with IBD in the 3 pediatric gastroenterology centers in Scotland has allowed us to document these aspects, notably the progression of disease location and behavior. Data
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J.V.L. and R.K.R. contributed equally to this manuscript. J.S. and D.C.W. are to be considered joint senior authors.
Johan Van Limbergen is funded by a Research Training Fellowship from Action Medical Research, The Gay-Ramsay-Steel-Maitland or Stafford Trust and the Hazel M Wood Charitable Trust. Elaine R Nimmo is supported by a Wellcome Trust Programme Grant (072789/Z/03/Z). Financial assistance was also provided by Schering–Plough and the GI/Nutrition Research Fund, Child Life and Health, University of Edinburgh.