Difference between early onset and late‐onset pediatric ulcerative colitis. Issue 9 (12th July 2016)

• Record Type: Journal Article
• Authors: Nambu, Ryusuke; Hagiwara, Shin‐ichiro; Kubota, Mitsuru; Kagimoto, Seiichi
• Is Part Of: Pediatrics international. Volume 58:Issue 9(2016)
• Page Start: 862
• Page End: 866
• Publication Date: 2016-07-12
• Subjects: children -- early onset -- infantile inflammatory bowel disease -- ulcerative colitis; Pediatrics -- Periodicals; 618.92
• DOI: 10.1111/ped.12935
• Languages: English
• ISSNs: 1328-8067

Abstract

Abstract: Background: Early onset pediatric ulcerative colitis (EO‐UC) is distinguished from late‐onset pediatric ulcerative colitis (LO‐UC) by the effects of genetic predisposition, but there have been few reports on the clinical features of EO‐UC in Asia. Methods: To describe and compare the presentation and disease course of EO‐UC (age range, 0–7 years) with those of LO‐UC (age range, 8–15 years), we retrospectively analyzed 63 children with UC who had been diagnosed between January 2004 and March 2014 at Saitama Children's Medical Center in Japan. Results: Ten patients (16%) had EO‐UC, and 53 (84%) had LO‐UC. All patients in the EO‐UC group and 70% in the LO‐UC group had pancolitis ( P = 0.05). The period from onset to diagnosis was 9.0 ± 14.1 months for EO‐UC and 2.6 ± 3.5 months for LO‐UC ( P < 0.01). The prevalence of extra‐intestinal complications at diagnosis was significantly higher for EO‐UC than for LO‐UC (50% vs 11%, respectively; P < 0.01). There were no significant differences in the use of corticosteroids, immunomodulators, immunosuppressants, or surgical risk between the groups but, in the EO‐UC group, only one patient was treated with cytapheresis and none was treated with anti‐tumor necrosis factor (TNF‐α) antibodies. Conclusions: The EO‐UC group had a higher incidence of pancolitis, longer diagnostic delay, and more extra‐intestinal manifestations than the LO‐UC group. Diagnosis and treatment may therefore be slightly more difficult for EO‐UC than for LO‐UC.