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Characteristics of the Inflammatory Bowel Disease in Children: A Croatian Single-Centre Retrospective Study
Ivan Pivac1, Antonia Jelicic Kadic2, Ranka Despot2
1School of Medicine, University of Split, Soltanska 2, 21000 Split, Croatia.
Insights
Pediatric Inflammatory Bowel Disease (IBD) in Croatia shows higher Crohn's disease (CD) rates and longer diagnostic delays in males. Rectal bleeding is more common in ulcerative colitis (UC) among children.
Area of Science:
- Gastroenterology
- Pediatrics
- Epidemiology
Background:
- Inflammatory bowel diseases (IBD), including ulcerative colitis (UC) and Crohn's disease (CD), are chronic conditions often diagnosed in childhood.
- Pediatric IBD cases exhibit distinct characteristics compared to adult-onset disease.
- Understanding regional pediatric IBD epidemiology is crucial for healthcare planning.
Purpose of the Study:
- To profile pediatric IBD patients in Croatia.
- To analyze demographic, clinical, and epidemiological features of IBD in children diagnosed between 2012 and 2021.
- To compare characteristics between UC and CD in the pediatric population.
Main Methods:
- Retrospective analysis of 107 pediatric IBD patients (up to 18 years) diagnosed at University Hospital of Split.
- Data collected from hospitalizations for diagnosis between January 1, 2012, and December 31, 2021.
- Analysis included patient demographics, symptom duration, diagnostic delay, incidence rates, BMI z-scores, and presenting symptoms.
Main Results:
- Croatia diagnosed 107 pediatric IBD cases; 55.1% CD, 43.9% UC.
- Median age at diagnosis was 14.1 years; males comprised 60.7%.
- CD patients had longer diagnostic delays (3.0 months vs. 2.0 months); rectal bleeding was more frequent in UC (72.3% vs. 32.2%).
Conclusions:
- This study provides a decade-long profile of pediatric IBD in Croatia, highlighting a predominance of CD and specific symptom differences between UC and CD.
- The findings underscore the need for continued research into pediatric IBD progression and management in this population.
- Further prospective studies are recommended to elucidate disease trajectories and optimize treatment strategies for Croatian children with IBD.
Abstract:
Inflammatory bowel diseases (IBDs), encompassing ulcerative colitis (UC) and Crohn's disease (CD), are chronic gastrointestinal disorders often diagnosed in youth, presenting unique features compared to adult-onset cases. We aimed to profile pediatric IBD patients in Croatia through a retrospective analysis of children up to 18 years old diagnosed with IBD at the University Hospital of Split from 1 January 2012, to 31 December 2021, utilizing data collected during hospitalization for diagnosis. Over a decade, 107 children were diagnosed, with 43.9% having UC, 55.1% CD, and 0.9% IBD-unclassified. Median age at diagnosis was 14.1 years, with UC patients being older (14.8 vs. 13.7 years, p = 0.044). Males constituted 60.7% of patients. Median symptom duration was 2.0 months, with CD patients experiencing a longer diagnostic delay (3.0 vs. 2.0 months, p = 0.003). The median incidence rate was 9.89 (95% CI 5.93-13.84) per 100,000 children/year, varying across age groups. Median (IQR) BMI z-score was -0.34 (-0.97-0.45). Common symptoms included diarrhea (60.7%) and abdominal pain (50.5%), with rectal bleeding more prevalent in UC (72.3% vs. 32.2%, p < 0.001). While our study offers valuable insights into pediatric IBD in Croatia, further prospective research is needed to clarify disease progression and development.
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