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Extraintestinal Manifestations in Children Diagnosed with Inflammatory Bowel Disease
Zubeyr Kavcar1, Hasret Ayyildiz Civan2, Didem Gulcu Taskin3
1Department of Pediatrics, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, İstanbul, Türkiye.
Insights
Extraintestinal manifestations (EIM) are frequent in pediatric inflammatory bowel disease (IBD) patients. These conditions are equally common in both ulcerative colitis (UC) and Crohn
Area of Science:
- Pediatric Gastroenterology
- Inflammatory Bowel Disease Research
- Clinical Manifestations
Background:
- Inflammatory Bowel Disease (IBD) encompasses chronic conditions like Crohn's disease (CD) and ulcerative colitis (UC).
- Extraintestinal manifestations (EIM) are common complications of IBD, affecting various organ systems.
- Understanding the prevalence and patterns of EIM in pediatric IBD is crucial for comprehensive patient management.
Purpose of the Study:
- To determine the frequency of extraintestinal manifestations (EIM) in children diagnosed with inflammatory bowel disease (IBD).
- To investigate the relationship between EIM and disease activity indices, disease type (CD vs. UC), and disease duration in pediatric IBD patients.
Main Methods:
- Retrospective analysis of medical records for pediatric patients (<18 years) diagnosed with IBD.
- Data collection included demographics, disease type, disease age, and EIM.
- Disease activity was assessed using the Pediatric Ulcerative Colitis Activity Index (PUCAI) for UC and Pediatric Crohn's Disease Activity Index (PCDAI) for CD.
Main Results:
- A total of 44 pediatric IBD patients (27.3% CD, 72.7% UC) were included.
- EIM were observed in a significant proportion of patients, with higher incidence in females (77.8%) than males (65.4%).
- Hepatobiliary (41.5%) and joint (29.5%) involvement were the most common EIM; prevalence was similar in CD (75%) and UC (68.8%).
Conclusions:
- Extraintestinal manifestations are a common occurrence in children with inflammatory bowel disease.
- The study highlights that EIM prevalence is comparable between ulcerative colitis and Crohn's disease in the pediatric population.
- Clinicians should be vigilant for EIM in pediatric IBD, irrespective of disease subtype.
Objectives:
We aimed to evaluate the frequency of extraintestinal manifestations (EIM) in children with inflammatory bowel disease (IBD) and the correlation of EIM with disease activity index, disease type and disease age.
Methods:
Records of patients who were under the 18 years of age and followed up with the diagnosis of IBD were included in the study. The demographic characteristics of the patients, the age of the patients, the sex of the patients, the type of disease and the age of the disease were recorded. When patients were enrolled in the study disease activity indexes were calculated by examining the physical examination and laboratory values of the patients in their last visits, by using the Pediatric Ulcerative Colitis Activity Index (PUCAI) in Ulcerative Colitis (UC) and the Pediatric Crohn's Disease Activity Index (PCDAI) in Crohn's Disease (CD).
Results:
It was conducted with a total of 44 patients, 40.9% (n=18) females and 59.1% (n=26) males diagnosed with IBD. The ages of the patients participating in the study ranged from 8 to 19 and the mean was found to be 14.64±3.19 years. According to the type of disease; 27.3% of the patients were CD and 72.7% were UC. When the disease activity is examined; 37.2% were in remission, 37.2% were mild, 16.3% moderate and 9.3% severe. The incidence of EIM in females is 77.8% and 65.4% in males. The incidence of EIM is 75% in CD and 68.8% in UC. Hepatobiliary involvement was detected in 41.5% (n=17) of the patients, joint involvement in 29.5% (n=13), osteopenia in bone in 16.3% (n=7), osteoporosis in 7% (n=3), ocular involvement (uveitis) in 2.3% (n=1) and skin involvement (erythema nodosum) in 2.3% (n=1).
Conclusion:
EIM are common in childhood IBD patients. It should be kept in mind that EIM are as common in UC as CD.
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