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Age and family history at presentation of pediatric inflammatory bowel disease
Toba A Weinstein1, Mindy Levine, Michael J Pettei
1Division of Pediatric Gastroenterology, Schneider Children's Hospital, North Shore-Long Island Jewish Health System, Albert Einstein College of Medicine, New Hyde Park, New York 11040, USA. weinstei@lij.edu
Insights
Young children with Crohn disease (CD) show higher platelet counts, lower BMI, and more family history of inflammatory bowel disease (IBD). Otherwise, initial presentations of pediatric IBD are similar across age groups.
Area of Science:
- Pediatric Gastroenterology
- Inflammatory Bowel Disease Research
- Clinical Pediatrics
Background:
- Young children with inflammatory bowel disease (IBD) are considered a distinct patient group.
- Understanding early clinical indicators in pediatric IBD is crucial for timely diagnosis and management.
Purpose of the Study:
- To compare the initial clinical presentation of IBD in young children versus older children.
- To investigate the association between a positive family history of IBD and the age of disease onset.
Main Methods:
- Retrospective review of 153 pediatric patients diagnosed with Crohn disease (CD) or ulcerative colitis (UC) between 1996 and 1999.
- Assessment of growth parameters, laboratory values (hemoglobin, platelets, ESR, albumin), and family history of IBD.
Main Results:
- Children with CD exhibited higher erythrocyte sedimentation rate, platelet count, and lower hemoglobin, albumin, and BMI compared to UC patients.
- Younger CD patients (<11 years) had significantly higher platelet counts and a greater frequency of positive family history of IBD than older CD patients.
- No other significant differences in initial presentation were observed between younger and older pediatric IBD patients.
Conclusions:
- Pediatric Crohn disease in young children is characterized by elevated platelet counts, reduced BMI, and increased familial predisposition.
- Apart from these specific markers, the initial clinical presentation of IBD in young children is largely comparable to that in older children.
Objectives:
Young children are thought to be a unique subset of pediatric patients with inflammatory bowel disease (IBD). The authors' objective was to evaluate the differences in initial clinical presentation of young and older children with IBD and to determine whether a positive family history of IBD is associated with the age of presentation.
Methods:
The authors reviewed the records of all patients with new diagnoses of Crohn disease (CD) and ulcerative colitis (UC) who presented between July 1996 and July 1999. Initial evaluation included assessment of growth parameters and laboratory values (hemoglobin concentration, platelet count, erythrocyte sedimentation rate, and serum albumin). Inquiry regarding a family history of IBD was made in every patient.
Results:
There were 153 patients with new diagnoses (82 with CD and 71 with UC), with a mean age of 11.9 years (range, 16 months-18 years). The children with CD had a higher sedimentation rate and platelet count and a lower mean hemoglobin concentration and serum albumin at presentation than did children with UC. Body mass index (BMI) was significantly lower in patients with newly diagnosed CD than in those with UC. The only significant laboratory differences between patients younger than 11 years and those 11 years or older was a higher mean platelet count in patients with CD who were younger than 11 years. Of the younger patients with CD, 41.7% had a positive family history of IBD, which was significantly greater that that found in the older patients with CD.
Conclusions:
Except for higher platelet counts, a lower BMI, and a higher frequency of positive family history in young children with CD, there were no significant differences in the presentation of young children with IBD compared with older children.
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