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Isolated Terminal Ileitis in Children

Arik Alper1, Aaron Bennett2, Douglas Rottmann3

  • 1From the Department of Pediatrics, Yale University, New Haven, CT.

Journal of Pediatric Gastroenterology and Nutrition
|February 2, 2023
PubMed

Insights

In children, isolated terminal ileitis often progresses to Crohn disease (CD). However, those with idiopathic terminal ileitis showed no CD development over 83 months, indicating a favorable long-term outcome.

Area of Science:

  • Pediatric Gastroenterology
  • Inflammatory Bowel Disease Research
  • Clinical Outcomes

Background:

  • Isolated terminal ileitis is uncommon in children, with limited data on its progression to Crohn disease (CD).
  • Understanding the natural history of pediatric isolated terminal ileitis is crucial for accurate diagnosis and management.
  • Distinguishing between Crohn disease and idiopathic terminal ileitis in children is clinically significant.

Approach:

  • Retrospective chart review of 956 children undergoing colonoscopy (2013-2017).
  • Analysis of clinical, endoscopic, histologic, and radiologic features.
  • Long-term follow-up of children diagnosed with isolated terminal ileitis.

Key Points:

  • Thirty-three children had isolated terminal ileitis; 17 developed CD, and 16 had idiopathic terminal ileitis.
  • Children with CD showed higher C-reactive protein levels, severe inflammation, and bowel wall thickening.
  • Idiopathic terminal ileitis cases did not progress to CD over an 83-month follow-up.

Conclusions:

  • Crohn disease is a common diagnosis in children presenting with isolated terminal ileitis.
  • Children with idiopathic terminal ileitis have a favorable long-term prognosis without progression to Crohn disease.
  • This study highlights key differences between Crohn disease and idiopathic terminal ileitis in pediatric populations.

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