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Inflammatory bowel disease in children 5 years of age and younger

Petar Mamula1, Grzegorz W Telega, Jonathan E Markowitz

  • 1Division of Gastroenterology and Nutrition, The Children's Hospital of Philadelphia, Pennsylvania 19104, USA.

The American Journal of Gastroenterology
|August 23, 2002
PubMed

Insights

Early onset inflammatory bowel disease (IBD) in children under five often presents with failure to thrive, particularly Crohn's disease (CD) and indeterminate colitis (IC), not ulcerative colitis (UC). Linear growth failure is common in pediatric CD.

Area of Science:

  • Pediatric Gastroenterology
  • Inflammatory Bowel Disease Research
  • Clinical Pediatrics

Background:

  • Inflammatory bowel disease (IBD) affects all ages, but its presentation in infants and young children is less understood.
  • Early diagnosis and characterization of IBD in pediatric populations are crucial for effective management.

Purpose of the Study:

  • To evaluate the clinical characteristics and outcomes of early-onset inflammatory bowel disease (IBD) in patients aged 5 years and younger.
  • To differentiate between Crohn's disease (CD), ulcerative colitis (UC), and indeterminate colitis (IC) in this young cohort.

Main Methods:

  • Retrospective review of medical records for patients diagnosed with early-onset IBD at The Children's Hospital of Philadelphia (1977-2000).
  • Categorization of patients into Crohn's disease (CD), ulcerative colitis (UC), and indeterminate colitis (IC) groups.
  • Analysis of clinical presentation, diagnostic changes, growth failure, disease extent, and serological markers.

Main Results:

  • Of 82 patients, 15% had their IBD diagnosis revised. Linear growth failure affected 29% with CD, 3% with UC, and 18% with IC.
  • Failure to thrive was common in CD (44%) and IC (39%), often leading to revised diagnoses from UC.
  • Pediatric CD frequently involved the large bowel (89%) and perianal region (34%).

Conclusions:

  • Failure to thrive at presentation suggests a final diagnosis of CD or IC, distinguishing it from UC in early-onset IBD.
  • Linear growth failure is a significant indicator in pediatric CD.
  • The IBD serology panel showed limited utility for definitive diagnosis in this pediatric cohort.
Abstract

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