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[Clinical characteristics of Crohn's disease in children and adults]
Y Menachem1, Z Weizman, C Locker
1Gastroenterological Institute, Soroka Medical Center, Beer Sheba.
Insights
Crohn's disease presents differently in children versus adults. Pediatric Crohn's disease often involves non-classical symptoms like anemia and joint pain, unlike the typical abdominal pain and diarrhea seen in adults.
Area of Science:
- Gastroenterology
- Pediatric Gastroenterology
- Internal Medicine
Background:
- Crohn's disease (CD) is a chronic inflammatory bowel disease.
- Limited research exists comparing clinical CD characteristics across different age demographics.
- Understanding age-specific presentations is crucial for timely diagnosis and management.
Purpose of the Study:
- To retrospectively compare the clinical characteristics of Crohn's disease in pediatric and adult patient cohorts.
- To identify age-related differences in presenting symptoms, disease activity, and manifestations of Crohn's disease.
Main Methods:
- Retrospective analysis of 23 pediatric patients (mean age 12.8 years) and 66 adult patients (mean age 27.0 years) diagnosed with Crohn's disease.
- Comparison of presenting symptoms, active disease symptoms, disease location, gastrointestinal complications, and extra-intestinal manifestations between the two groups.
Main Results:
- Adults more frequently presented with abdominal pain and diarrhea; children with anorexia and weight loss.
- Children exhibited a higher prevalence of extra-gastrointestinal symptoms, notably anemia and joint involvement.
- Anemia and weight loss were more consistently observed during active disease in children compared to adults.
Conclusions:
- Pediatric Crohn's disease exhibits distinct clinical features compared to adult CD, often presenting with non-classical symptoms.
- Anemia and joint involvement are significant indicators of Crohn's disease in children.
- Primary care physicians must recognize these age-specific differences for accurate pediatric Crohn's disease diagnosis.
Abstract:
There are few reports contrasting the clinical characteristics of Crohn's disease in different age groups. We therefore compared retrospectively children and adults with Crohn's disease. 23 children (mean age: 12.8 +/- 2.5 years) and 66 adults (mean age: 27.0 +/- 4.0 years) were studied. Presenting symptoms of abdominal pain and diarrhea were significantly more common in adults, while in children anorexia and weight loss were more frequent. Children tended to present with extra-gastrointestinal tract symptoms as well, mainly anemia and joint involvement. Common symptoms during active disease did not differ between groups, except that weight loss, evident in all children, was found in only 70% of adults. Anemia was present during active disease in all pediatric cases but in only 62% of adults. There were no significant differences between groups regarding disease location, gastrointestinal complications and extra-intestinal manifestations. We conclude that in children Crohn's disease may differ significantly, mainly presenting with nonclassical symptoms, such as anemia and joint involvement. The primary care physician should be aware of these differences.