Related Experiment Video
Updated: Dec 21, 2025
Development of a Hepatitis B Virus Reporter System to Monitor the Early Stages of the Replication Cycle
Published on: February 1, 2017
A Multicenter Prospective Survey on Early-Onset Inflammatory Bowel Disease in Japan
Takahiro Kudo1, Tohru Fujii2, Shun-Ichi Maisawa3,4
1Department of Pediatrics, Juntendo University Faculty of Medicine, Tokyo, Japan, t-kudo@juntendo.ac.jp.
Insights
Early-onset inflammatory bowel disease (IBD) in Japanese children under 8 years old shows distinct patterns. Crohn's disease (CD) often involves the colon, while ulcerative colitis (UC) frequently presents as pancolitis, necessitating further investigation into underlying conditions.
Area of Science:
- Pediatric Gastroenterology
- Inflammatory Bowel Disease Research
- Clinical Epidemiology
Background:
- The incidence of early-onset inflammatory bowel disease (IBD) is rising in Japan.
- Understanding the specific characteristics of IBD in young children is crucial for effective management.
Purpose of the Study:
- To analyze the treatment strategies and clinical progression of early-onset inflammatory bowel disease (IBD) in Japanese patients under 8 years old.
- To identify disease patterns and outcomes in pediatric Crohn's disease (CD) and ulcerative colitis (UC).
Main Methods:
- A prospective survey of 43 patients diagnosed with IBD before age 8.
- Data collection and analysis covered the period from diagnosis up to 36 months post-registration.
- Evaluation included disease type, lesion location, treatment response, and long-term outcomes.
Main Results:
- Of 43 patients, 12 had Crohn's disease (CD) and 21 had ulcerative colitis (UC). Mean onset age was 3 years, 7 months.
- CD patients frequently presented with colon (100%) and anal (50%) lesions; 41.7% had granulomas. UC patients often had pancolitis (71.4%) and moderate severity (66.7%).
- Initial treatment achieved remission in 91.7% of CD patients (72.7% sustained for 36 months) and 85.7% of UC patients (15.8% sustained for 36 months). Anal complications were more common in infantile-onset IBD.
Conclusions:
- In Japanese children under 8, CD is more commonly colitis-type, and UC is more frequently pancolitis.
- Severe disease courses observed in some patients highlight the importance of investigating primary immunodeficiency.
- Early identification of underlying conditions is essential for managing severe pediatric IBD cases.
Introduction:
The incidence of early-onset inflammatory bowel disease is increasing in Japan.
Objective:
This study aimed to analyze the treatment and progress of early-onset inflammatory bowel disease.
Methods:
This prospective survey evaluated the data of 43 patients aged <8 years who were diagnosed with inflammatory bowel disease (IBD) from the time of diagnosis to 36 months after registration.
Results:
A total of 12 patients with Crohn's disease (CD), 21 with ulcerative colitis (UC), and 3 with unclassified IBD were enrolled. The mean disease onset age was 3 years and 7 months. Colon and anal lesions were present in 100 and 50% of patients with CD, respectively. Granulomas were detected in 5 patients (41.7%). Dietary elimination including elemental diet was performed in all patients. Eleven patients (91.7%) were in remission by initial induction therapy, and 72.7% maintained remission for 36 months. Three patients (14.3%) with UC had familial history, 71.4% had pancolitis-type UC, and 66.7% exhibited disease of moderate severity. Colectomy was performed in 4 patients (21.1%). Eighteen patients (85.7%) were in remission by initial induction therapy; however, only 15.8% maintained remission for 36 months. Anal complication was more prevalent in infantile-onset IBD than in childhood-onset IBD (p = 0.014).
Conclusions:
Among Japanese patients aged <8 years who were diagnosed with IBD, colitis-type disease was more common in CD and pancolitis was more common in UC. As the courses of several patients were severe, identifying primary immunodeficiency appears to be necessary to confirm background disease.
