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Outcome of Crohn's disease diagnosed before two years of age
George Marx1, Ernest G Seidman, Steven R Martin
1Division of Pediatric Gastroenterology and Nutrition, Department of Pediatrics, Sainte-Justine Hospital, University of Montreal, Montreal, Québec, Canada.
Insights
Early-onset Crohn's disease in young children can lead to prolonged remission with medical or surgical treatment. However, significant illness and death can occur, with some patients experiencing malnutrition and growth failure.
Area of Science:
- Pediatric Gastroenterology
- Inflammatory Bowel Disease Research
- Clinical Case Series
Background:
- Crohn's disease (CD) is a chronic inflammatory bowel disease.
- Early-onset CD, diagnosed in infancy or early childhood, presents unique challenges.
- Understanding the long-term outcomes of very early-onset CD is crucial for patient management.
Observation:
- This study reports on seven patients diagnosed with Crohn's disease before the age of two years.
- The clinical course, treatment responses, and outcomes of these young patients were meticulously documented.
- Key observations included the occurrence of malnutrition, growth failure, and treatment-related complications.
Findings:
- Five out of seven patients achieved prolonged remission through medical management.
- One patient required surgical intervention for disease management.
- One patient succumbed to disseminated adenovirus infection, highlighting potential mortality risks.
- Three patients experienced significant morbidity, including malnutrition and growth failure.
Implications:
- Very early-onset Crohn's disease does not invariably predict a poor prognosis.
- Aggressive management strategies are necessary to mitigate significant morbidity and mortality risks in this population.
- Further research is warranted to optimize therapeutic approaches for infants and toddlers with Crohn's disease.
Abstract:
We describe the course of 7 patients younger than 2 years with Crohn's disease. Prolonged remission was achieved medically (5) or surgically (1), whereas one patient died of disseminated adenovirus. Three had malnutrition and growth failure. Crohn's disease very early in life does not always imply a poor prognosis; however, significant morbidity and mortality are encountered.