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Association of paediatric inflammatory bowel disease with other immune-mediated diseases
Michael D Kappelman1, Joseph A Galanko, Carol Q Porter
1Division of Pediatric Gastroenterology, Department of Pediatrics, University of North Carolina Chapel Hill, 130 Mason Farm Road, Campus Box 7229, Chapel Hill, NC 27599, USA. michael_kappelman@med.unc.edu
Insights
Children with inflammatory bowel diseases (IBD) have a higher risk of developing other immune-mediated conditions, especially Crohn's disease (CD). This finding suggests shared causes and highlights the increased burden of pediatric IBD.
Area of Science:
- Pediatric Rheumatology
- Gastroenterology
- Immunology
Background:
- Adult studies show links between inflammatory bowel diseases (IBD) and other immune-mediated diseases.
- Such associations in childhood-onset IBD are not well-established.
Purpose of the Study:
- To investigate the association between pediatric IBD and other immune-mediated diseases.
- To determine if children diagnosed with Crohn's disease (CD) or ulcerative colitis (UC) have a higher prevalence of other immune conditions.
Main Methods:
- Retrospective analysis of administrative data from 87 health plans.
- Identified pediatric cases (≤20 years) of CD and UC, matched with three controls each.
- Used logistic regression to compare the prevalence of immune-mediated diseases using ICD-9 codes.
Main Results:
- Crohn's disease (CD) showed significant associations with rheumatoid arthritis, lupus, and hypothyroidism.
- Ulcerative colitis (UC) was associated with a higher prevalence of diabetes.
- Trends indicated increased risks for asthma, eczema, allergic rhinitis, and other conditions in both CD and UC patients.
Conclusions:
- Pediatric IBD, particularly CD, is linked to an increased risk of immune-mediated conditions.
- This comorbidity underscores the significant burden of pediatric IBD.
- The findings suggest potential common underlying etiological mechanisms for these associated diseases.
Background:
Associations between inflammatory bowel diseases (IBDs) and other immune-mediated diseases have been described in adult populations. Whether such associations exist in childhood-onset disease remains unknown.
Objectives:
The authors sought to evaluate whether paediatric IBD is associated with the occurrence of other immune-mediated diseases.
Study Design:
The authors identified cases of Crohn's disease (CD) and ulcerative colitis (UC), ≤20 years of age, using administrative data from 87 health plans. Each case was matched to three controls, on the basis of age, gender, and geographical region. The authors used logistic regression to compare the prevalence of various immune-mediated diseases (identified by International Classification of Diseases, ninth revision codes) in cases versus controls.
Results:
The study included 737 children with CD (1997 controls) and 488 with UC (1310 controls). CD was associated with a higher prevalence of rheumatoid arthritis (OR 15.7, 95% CI 4.6 to 53.7), lupus (OR 41.0, 95% CI 2.3 to 719.1) and hypothyroidism (OR 2.9, 95% CI 1.4 to 6.1), with a trend toward an increased prevalence of asthma, eczema, allergic rhinitis and diabetes. UC was associated with a higher prevalence of diabetes (OR 2.7, 95% CI 1.1 to 6.6), with a trend towards increased prevalence of asthma, eczema, allergic rhinitis, hypothyroidism, rheumatoid arthritis and lupus.
Discussion:
Children with IBD, particularly CD, have an elevated risk for immune-mediated conditions. This comorbidity adds to the burden of paediatric IBD, and suggests common aetiologic mechanisms.
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