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Extraintestinal manifestation of inflammatory bowel disease and associated factors in pediatric patients
Parisa Rahmani1, Ghazaleh Rasti1, Mojtaba Gorgi2
1Pediatric Gastroenterology and Hepatology Research Center, Children's Medical Center, Pediatric Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran.
Insights
Oral plaque severity correlates with disease severity in pediatric inflammatory bowel disease (IBD). Standardizing scoring systems is recommended for better assessment of extraintestinal manifestations in Crohn's disease and ulcerative colitis.
Area of Science:
- Pediatric Gastroenterology
- Inflammatory Bowel Disease Research
- Clinical Manifestations of IBD
Background:
- Extraintestinal manifestations (EIMs) are common in pediatric inflammatory bowel disease (IBD), affecting various organ systems.
- Understanding factors influencing IBD severity and EIMs is crucial for effective patient management.
Purpose of the Study:
- To investigate factors determining disease severity in pediatric IBD.
- To evaluate the prevalence and associations of extraintestinal manifestations (EIMs) in pediatric Crohn's disease (CD) and ulcerative colitis (UC).
- To assess the utility of disease activity scoring systems in relation to EIMs.
Main Methods:
- A cross-sectional study involving 73 pediatric patients with IBD (CD and UC).
- Data collected included medical history, gastrointestinal complications, and incidence of EIMs.
- Disease activity was assessed using the Pediatric Crohn's Disease Activity Index (PCDAI) for CD and the Pediatric Ulcerative Colitis Activity Index (PUCAI) for UC.
Main Results:
- The study included 54.80% with UC and 45.20% with CD.
- Prevalent symptoms included weight loss, diarrhea, and abdominal pain in both CD and UC.
- The most common EIMs were arthritis (21.21% in CD, 12.5% in UC), oral plaque (15.15% in CD), and erythema nodosum (6.06% in CD).
Conclusions:
- Oral plaque severity showed a positive association with overall disease severity in pediatric IBD.
- No significant associations were found between other assessed parameters and disease severity or EIMs.
- Standardization of scoring systems is recommended for accurately determining EIMs in IBD.
Objective:
Extraintestinal manifestations in irritable bowel disease (IBD), Crohn's disease and ulcerative colitis are reported in different system of the body. We aimed to investigate the factors determining disease severity and evaluate extraintestinal manifestations in patients with irritable bowel disease based on disease activity scoring system.
Methods:
This cross-sectional study was conducted on all patients with irritable bowel disease referred to clinic and gastroenterology ward of (XXX). Medical history, gastrointestinal complications and incidence of extraintestinal manifestations were recorded. Disease severity in ulcerative colitis was rated based on PUCAI (Pediatric Ulcerative Colitis Activity Index) score and in Crohn's disease was calculated based on PCDAI (Pediatric Crohn's Disease Activity Index) score.
Results:
Of 73 children included in our study, 54.80% were diagnosed with ulcerative colitis and 45.20% were diagnosed with Crohn's disease. The most prevalent symptom was weight loss (81.81%), diarrhea (72.72%) and abdominal pain (69.69%) in Crohn's diseases and bloody diarrhea (80%), abdominal pain (77.5%) and weight loss (57.5%) in ulcerative colitis. The average of PCDAI score was 43.44 and PUCAI score was 35.62. The most prevalent extraintestinal manifestation of the disease was arthritis in 7 Crohn's disease patients (21.21%) and 5 patients (12.5%) with ulcerative colitis, oral plague in 5 patients (15.15%) with Crohn's disease and erythema nodosum in 2 patients (6.06%) with Crohn's disease.
Conclusion:
The severity of oral plaque was positively associated with the severity of the disease. There was no significant association among other parameters. Scoring systems, to determine the extraintestinal manifestation, should be standardized based on the scoring outcomes.
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