Baseline Characteristics and Disease Phenotype in Inflammatory Bowel Disease
Journal of Pediatric Gastroenterology and Nutrition - JPGN
words Abstract Background and Aims: Predicting short-term relapses and long-term prognosis is of outmost importance in paediatric inflammatory bowel disease. Our aim was to investigate the short-term disease outcome and medication during the first year in a paediatric incident cohort from Hungary. In addition, association laboratory markers and disease activity indices with shortterm disease outcome and medication were analysed. Methods: From January 1, 2008 to December 31, 2010 demographic
... and clinical characteristics of newly diagnosed paediatric inflammatory bowel disease patients younger than 18 years of age were prospectively recorded. Results: A total of 420 patients were identified [Crohn's disease: 266; ulcerative colitis 124]. Initially, 48% (124/256) of Crohn's disease patients had moderate to severe disease (PCDAI>31), and this rate decreased to 2.1% at one-year follow-up. Proportion of ulcerative colitis patients with moderate to severe disease (PUCAI>35) at diagnosis declined from 57.5% (69/120) to 6.8% at one-year follow-up. Terminal ileal involvement correlated with higher initial CRP (p=0.021) and initial PCDAI (p=0.026). In ulcerative colitis, elevated CRP (p=0.002) was associated with disease extension. CRP and PCDAI at diagnosis were associated with the need for immunomodulators at one year in children with Crohn's disease. Initial CRP was also associated with the need for immunomodulators in patients with ulcerative colitis at one-year follow-up. Conclusions: At diagnosis half of the patients with inflammatory bowel disease had moderate to severe disease and this rate decreased to less than 10% after one year. Initial CRP and PCDAI were related to the need for aggressive therapy in Crohn's disease. What is known • Predicting short-and long-term prognosis would be essential in the management of IBD • Some studies described, that initial CRP is associated with short-and long-term disease course. • Relationship of pediatric IBD acitivity indeces and prognosis has not been investigated. What is new • Initially half of the patients had moderate to severe disease, this rate decreased to less than 10% after one year. • Initially elevated CRP was associated with the need of immunomodulator at one year in CD and UC. • PCDAI at baseline was associated with the need of aggressive therapy.