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Changing pattern of paediatric inflammatory bowel disease in northern Stockholm 1990-2001
H Hildebrand1, Y Finkel, L Grahnquist
1Department of Women and Child Health, Astrid Lindgren Children's Hospital, Stockholm, Sweden. hans.hildebrand@ks.se
Insights
The incidence of pediatric Crohn's disease (CD) has significantly increased in northern Stockholm, surpassing rates in other regions. Ulcerative colitis (UC) incidence remained stable, indicating a shift towards CD in pediatric inflammatory bowel disease (IBD).
Area of Science:
- Pediatric Gastroenterology
- Epidemiology
- Immunology
Background:
- Recent reports indicate a rising incidence of pediatric Crohn's disease.
- Understanding trends in pediatric inflammatory bowel disease (IBD) is crucial for public health.
Purpose of the Study:
- To determine the incidence and characteristics of pediatric IBD in northern Stockholm from 1990 to 2001.
- To analyze trends in Crohn's disease (CD) and ulcerative colitis (UC) within this population.
Main Methods:
- Population-based study of 180,000 individuals aged 0-15 years.
- Inclusion criteria: suspected IBD based on defined diagnostic criteria.
- Data collection included family history of IBD and co-occurring autoimmune diseases.
Main Results:
- 152 children diagnosed with IBD; overall incidence 7.4 per 100,000.
- Crohn's disease (CD) incidence was 4.9, ulcerative colitis (UC) 2.2.
- Significant increase in CD incidence, stable UC incidence; male predominance in CD. 14% of CD patients had a family history of IBD. 18% had autoimmune diseases. 10% of CD patients required surgery.
Conclusions:
- Pediatric Crohn's disease incidence has markedly increased in northern Stockholm.
- A diagnostic shift from UC towards CD is suggested, alongside an overall rise in pediatric IBD.
- Family history and autoimmune comorbidities are prevalent in pediatric IBD cases.
Background:
An increased incidence of paediatric Crohn's disease was reported recently by our group.
Aims:
To assess the incidence and characteristics of inflammatory bowel disease (IBD) in northern Stockholm between 1990 and 2001.
Methods:
All records of individuals 0-15 years of age with suspected IBD in the population based catchment area of 180000 individuals were scrutinised using defined diagnostic criteria. Patient files were searched for relatives with IBD, and for concomitant autoimmune diseases.
Results:
A total of 152 children were diagnosed with IBD, corresponding to an overall incidence (per 100000) of IBD of 7.4. The incidence of Crohn's disease (CD) was 4.9, ulcerative colitis (UC) 2.2, and indeterminate colitis 0.2. Between 1990 and 2001, there was a marked increase in the incidence of CD while the incidence of UC was almost unchanged, leading to a net increase in the overall occurrence of IBD. There was a male dominance of CD. Fourteen per cent and 11% of patients with CD and UC, respectively, had a first or second degree relative with IBD. Eighteen per cent and 10% of patients with CD and UC, respectively, had a concomitant autoimmune disease. Ten patients with CD (10%) underwent surgery.
Conclusions:
The incidence of CD has increased in northern Stockholm. The current incidence is higher than that reported from other areas. Our results suggest a shift in presentation and diagnosis from UC towards CD, but also a net increase in IBD. Concomitant autoimmune disorders and family history are common in paediatric IBD.
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