Timmer Antje, Stark Renee, Peplies Jenny, Classen Martin, Laass Martin W, Koletzko Sibylle
aDepartment of Health Services Research, Medical Faculty, Division of Epidemiology and Biometry, Carl von Ossietzky University, Oldenburg bDepartment of Clinical Epidemiology, Leibniz Institute for Prevention Research and Epidemiology - BIPS GmbH cFaculty of Human and Health Sciences, Institute for Public Health and Nursing Research IPP dChildrens Hospital, Klinikum Links der Weser, Bremen eInstitute for Health Economics and Healthcare Management, Helmholtz Zentrum München, Neuherberg fDr. von Hauner Children's Hospital, Ludwig Maximilian University, Munich gChildren's Hospital, Medical Faculty Carl Gustav Carus, Technical University Dresden, Dresden, Germany.
Eur J Gastroenterol Hepatol. 2017 Nov;29(11):1276-1283. doi: 10.1097/MEG.0000000000000956.
There are inconsistent reports on age-related differences in inflammatory bowel disease (IBD). On the basis of patient information, we describe the clinical presentation and therapy in relation to age at diagnosis in longstanding pediatric IBD.
Two surveys were conducted in children and young adults (age: 10-25 years) by pretested postal questionnaires. The main analyses are descriptive, showing proportions and distributions per grouped age of diagnosis. Exploratory logistic regression was used to identify sociodemographic and disease-related factors associated with prognosis. Recent disease course, use of biological therapy, and resecting surgery were chosen as indicators of disease severity. Patients with a diagnosis in infancy (<2 years of age) are presented as a case series.
Information of 1280 cases was available [804 Crohn's disease (CD), 382 ulcerative colitis (UC), 94 IBD not specified] (response: 44.6 and 49.6%). Stable remission during the preceding year was reported by 675 (56.7%) patients; 825 (60.9%) patients reported feeling currenty well. Anti-tumor necrosis factor therapy was reported by 33% of CD patients and 9.3% of UC patients, immunomodulation in 82.1 and 63.2%, and corticosteroids by 78.4 and 76.1%, respectively (ever use). Age at diagnosis was not associated with indicators of severe disease. Diagnosis in infancy was reported by 37 patients.
Our data do not support age at diagnosis-related differences in prognosis in pediatric-onset IBD.
关于炎症性肠病（IBD）与年龄相关差异的报道并不一致。基于患者信息，我们描述了长期儿科IBD患者的临床表现及诊断时年龄相关的治疗情况。
通过预先测试的邮政问卷对儿童和青年（年龄10 - 25岁）进行了两项调查。主要分析为描述性分析，显示每个诊断分组年龄的比例和分布情况。采用探索性逻辑回归来确定与预后相关的社会人口统计学和疾病相关因素。选择近期疾病病程、生物治疗的使用情况以及切除手术作为疾病严重程度的指标。将婴儿期（<2岁）诊断的患者作为病例系列呈现。
获得了1280例患者的信息[804例克罗恩病（CD），382例溃疡性结肠炎（UC），94例未明确的IBD]（回复率分别为44.6%和49.6%）。675例（56.7%）患者报告前一年病情稳定缓解；825例（60.9%）患者报告目前感觉良好。分别有33%的CD患者和9.3%的UC患者报告使用抗肿瘤坏死因子治疗，82.1%的CD患者和63.2%的UC患者使用免疫调节剂，78.4%的CD患者和76.1%的UC患者使用皮质类固醇（曾使用）。诊断时年龄与严重疾病指标无关。37例患者报告在婴儿期被诊断。
我们的数据不支持儿科发病IBD在诊断时年龄与预后相关差异的观点。
