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Prevalence and clinical features of chronic uveitis in pediatric inflammatory bowel diseases: A nationwide study
Valerio Maniscalco1, Luca Scarallo2,3, Marina Aloi4
1Rheumatology Unit, ERN-ReCONNET Center, Meyer Children Hospital IRCCS, Florence, Italy.
Insights
Uveitis, an eye condition, is a rare complication in pediatric Inflammatory Bowel Disease (IBD). This study found a low prevalence of uveitis in children with IBD, with most cases showing inactive disease and IBD at follow-up.
Area of Science:
- Ophthalmology
- Gastroenterology
- Pediatrics
Background:
- Inflammatory Bowel Disease (IBD) comprises chronic gastrointestinal inflammatory disorders.
- Ocular manifestations, particularly uveitis, can occur in IBD patients.
- Pediatric IBD presents unique challenges in managing extra-intestinal complications.
Purpose of the Study:
- To determine the prevalence of uveitis in a nationwide cohort of pediatric Inflammatory Bowel Disease patients.
- To describe the clinical features and outcomes of uveitis in this population.
- To assess the relationship between IBD activity and ocular involvement.
Main Methods:
- Retrospective analysis of a nationwide cohort of pediatric IBD patients.
- Identification of patients diagnosed with uveitis.
- Review of medical records for clinical characteristics, IBD type, uveitis onset, and follow-up data.
Main Results:
- Six cases of uveitis were identified among 4229 pediatric IBD patients, yielding a prevalence of 141.8 per 100,000.
- Uveitis onset occurred before, after, or concurrently with IBD diagnosis.
- All identified uveitis cases involved anterior segment inflammation; 2/6 were symptomatic. At follow-up, most patients had quiescent IBD and inactive uveitis, though one experienced ocular complications.
Conclusions:
- Uveitis is an uncommon but significant ocular complication in pediatric Inflammatory Bowel Disease.
- Early recognition and management are crucial for favorable outcomes.
- Further research is warranted to elucidate the pathogenesis and optimize treatment strategies.
Abstract:
Inflammatory bowel diseases (IBD) encompass a group of chronic inflammatory disorders primarily affecting the gastrointestinal tract but capable of impacting various organs, including the eye, with uveitis being the most common ocular condition. We assessed uveitis prevalence and clinical features in a nationwide cohort of pediatric IBD. Among 4229 cases, six patients (four Crohn's disease, one ulcerative colitis, and one unclassified IBD) were identified, resulting in an overall prevalence rate of 141.8 per 100,000 patients. Uveitis onset varied: two before IBD, two after, and two concomitantly. Symptomatic uveitis occurred in 2/6 patients, with anterior involvement in all cases. Median follow-up was 3 years (interquartile range 2-4.75 years). At the last follow-up, 5/6 patients exhibited quiescent IBD, while 4/6 had inactive uveitis. One patient had ocular complications. Uveitis is a rare but potentially complicating manifestation of pediatric IBD.
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