Related Experiment Video
Updated: Jul 3, 2026
Chronic Salmonella Infection Induced Intestinal Fibrosis
Published on: September 22, 2019
Development of extraintestinal manifestations in pediatric patients with inflammatory bowel disease
Folashade Adebisi Jose1, Elizabeth A Garnett, Eric Vittinghoff
1Department of Pediatric Gastroenterology Hepatology and Nutrition, San Francisco, California 94143, USA. Josef@peds.ucsf.edu
Insights
Extraintestinal manifestations (EIMs) affect 6% of pediatric inflammatory bowel disease (IBD) patients at diagnosis. Within 15 years, nearly a third of children with IBD will develop an EIM, with arthritis and osteopenia being most common.
Area of Science:
- Pediatric gastroenterology
- Inflammatory bowel disease (IBD) research
- Clinical epidemiology
Background:
- Extraintestinal manifestations (EIMs) in pediatric inflammatory bowel disease (IBD) are not well understood.
- Characterizing EIMs at diagnosis and their subsequent incidence is crucial for patient management.
Purpose of the Study:
- To determine the prevalence of EIMs at diagnosis in pediatric IBD patients.
- To investigate the incidence of EIMs after IBD diagnosis and identify associated risk factors.
Main Methods:
- Analysis of data from 1649 pediatric patients in the PediIBD Consortium Registry.
- Utilized logistic regression, Kaplan-Meier, log rank tests, and Cox models to analyze EIM prevalence and incidence.
Main Results:
- 6% of pediatric IBD patients had EIMs at diagnosis, with arthritis and aphthous stomatitis being most common.
- Cumulative incidence of EIMs reached 29% by 15 years post-diagnosis, with arthritis and osteopenia/osteoporosis being most frequent.
- EIM incidence was independent of IBD type, age at diagnosis, and race/ethnicity, but may be slightly higher in girls.
Conclusions:
- A significant proportion of pediatric IBD patients experience EIMs before and after diagnosis.
- The development of EIMs in pediatric IBD is a long-term concern, impacting nearly a third within 15 years.
- While EIM type varies, their occurrence is largely independent of demographic and disease classification factors in this cohort.
Background:
Extraintestinal manifestations (EIMs) in pediatric patients with inflammatory bowel disease (IBD) are poorly characterized. We examined the prevalence of EIMs at diagnosis, subsequent incidence, and risk factors for EIMs.
Methods:
Data for 1649 patients from the PediIBD Consortium Registry, diagnosed with IBD before 18 years of age (1007 [61%] with Crohn's disease, 471 [29%] with ulcerative colitis, and 171 [10%] with indeterminate colitis), were analyzed using logistic regression, Kaplan-Meier, log rank tests, and Cox models.
Results:
EIMs were reported prior to IBD diagnosis in 97 of 1649 patients (6%). Older children at diagnosis had higher rates compared with younger children, and arthritis (26%) and aphthous stomatitis (21%) were most common. Among the 1552 patients without EIM at diagnosis, 290 developed at least 1 EIM. Kaplan-Meier estimates of cumulative incidence were 9% at 1 year, 19% at 5 years, and 29% at 15 years after diagnosis. Incidence did not differ by IBD type (P = 0.20), age at diagnosis (P = 0.22), or race/ethnicity (P = 0.24). Arthritis (17%) and osteopenia/osteoporosis (15%) were the most common EIMs after IBD diagnosis.
Conclusions:
In our large cohort of pediatric IBD patients, 6% had at least 1 EIM before diagnosis of IBD. At least 1 EIM will develop in 29% within 15 years of diagnosis. The incidence of EIMs both before and after diagnosis of IBD differs by type of EIM and may be slightly higher in girls, but is independent of the type of IBD, age at diagnosis, and race/ethnicity.
Related Concept Videos
01:20Inflammatory Bowel Disease IV: Clinical Manifestations
01:30Inflammatory Bowel Disease II: Crohn's Disease
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by transmural...
01:27Inflammatory Bowel Disease I: Ulcerative Colitis
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
01:25Inflammatory Bowel Disease III: Crohn's Disease
01:17Chronic Bowel Disorders: Introduction
Irritable Bowel Syndrome (IBS) is a common disorder affecting the gastrointestinal tract. The distinctive feature is recurrent abdominal pain associated with altered bowel movements, manifesting as constipation, diarrhea, or fluctuating between both. The...
01:26Inflammatory Bowel Disease I: Introduction