Comparison of longstanding pediatric-onset and adult-onset Crohn's disease.

INTRODUCTION

Limited information is available on the characteristics of longstanding Crohn's disease with onset in childhood or adolescence.

MATERIALS AND METHODS

In this retrospective study, 224 patients with pediatric-onset Crohn's disease were compared to a group of patients with disease diagnosed as adults.

RESULTS

More than 50% of the patients in the pediatric-onset group were followed for more than a decade, with a mean follow-up of 12.2 years. There were 96 male (42.9%) and 128 female (57.1%) patients. Most had disease diagnosed in adolescence. The female predominance, similar to adult-onset disease, was noted only among patients with disease diagnosed in adolescence (13-19 years), not in childhood. Disease most often involved both ileum and colon (128 of 224; 57.1%). Isolated ileal or colonic disease was less common. Upper gastrointestinal tract disease was present in 42 of 224 (18.8%) patients. The incidence of strictures (28.6%) and penetrating complications (46.4%) was similar to that of adults followed for the same period of time.

CONCLUSION

In pediatric-onset Crohn's disease, female-predominance emerges during adolescence. Pediatric-onset disease is more extensive than adult-onset disease. When followed for an extended period of time, it has high rates of disease complexity, with strictures and penetrating complications similar to adult-onset disease.