Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea.
J Crohns Colitis. 2022 Feb 23;16(2):207-215. doi: 10.1093/ecco-jcc/jjab132.
The long-term outcomes of paediatric-onset inflammatory bowel disease [pIBD] in non-Caucasian populations are unknown. We therefore evaluated and compared the clinical features and long-term outcomes of pIBD with those of adult-onset IBD [aIBD] using a population-based cohort in the Songpa-Kangdong district of Seoul, Korea.
Clinical characteristics and prognoses were compared between the two groups: pIBD [defined as <18 years of age at diagnosis] and aIBD [18-59 years of age at diagnosis].
We identified 131 patients with pIBD (48 ulcerative colitis [UC], 83 Crohn's disease [CD]) and 1192 patients with aIBD [866 UC, 326 CD] during 1986-2015. Extensive colitis at diagnosis was more prevalent in pUC than in aUC [45.8% vs 22.3%, p < 0.001], and the overall exposure to corticosteroids, thiopurines and anti-tumour necrosis factor agents was higher in pUC than in aUC [p < 0.001]. The cumulative risk of colectomy was higher in pUC than in aUC during a median follow-up of 125.0 and 112.1 months, respectively [8.9% vs 1.8% at 10 years after diagnosis, p = 0.030]. Ileocolonic location and inflammatory behaviour at diagnosis were more common in pCD than in aCD; however, patients with pCD and aCD did not differ regarding treatment or disease course during a median follow-up of 137.2 and 120.9 months, respectively.
Our study showed clear differences between pIBD and aIBD, especially in UC. pUC presents with more extensive diseases and may have a more severe disease course, as suggested by an earlier time to administering medications and performing colectomy.
非白种人群中儿童发病炎症性肠病（pIBD）的长期预后尚不清楚。因此，我们使用韩国首尔松坡-姜洞地区的一个基于人群的队列，评估并比较了 pIBD 与成人发病炎症性肠病（aIBD）的临床特征和长期预后。
比较了两组患者的临床特征和预后：pIBD（定义为诊断时年龄<18 岁）和 aIBD（诊断时年龄 18-59 岁）。
我们在 1986-2015 年期间共发现 131 例 pIBD 患者（48 例溃疡性结肠炎[UC]，83 例克罗恩病[CD]）和 1192 例 aIBD 患者（866 例 UC，326 例 CD）。pUC 患者诊断时广泛性结肠炎更为常见（45.8% vs 22.3%，p<0.001），且 pUC 患者总体接受皮质类固醇、巯嘌呤和抗肿瘤坏死因子药物治疗的比例高于 aUC 患者（p<0.001）。在中位随访 125.0 和 112.1 个月时，pUC 患者的结肠切除术累积风险均高于 aUC 患者[分别为诊断后 10 年的 8.9% vs 1.8%，p=0.030]。pCD 患者的诊断时病变部位为回结肠和炎症性表现更为常见；然而，在中位随访 137.2 和 120.9 个月时，pCD 患者和 aCD 患者的治疗或疾病过程并无差异。
本研究表明 pIBD 和 aIBD 之间存在明显差异，尤其是在 UC 中。pUC 患者的疾病更为广泛，可能具有更严重的疾病过程，这反映在更早开始使用药物和进行结肠切除术。
