From the Division of Pediatric Gastroenterology, Hepatology and Nutrition, Marmara University School of Medicine, Istanbul, Turkey.
J Pediatr Gastroenterol Nutr. 2022 Oct 1;75(4):e61-e66. doi: 10.1097/MPG.0000000000003557. Epub 2022 Sep 20.
It is not clear whether the characteristics of pediatric inflammatory bowel disease (IBD) differ between Eastern and Western countries. The aim of this study was to analyze the characteristics of PIBD in Turkey, according to the age at diagnosis.
The data of 176 children with IBD who were followed in our center were analyzed. Patients were divided into early (EO-IBD, onset at 2 to <10 years) and later-onset (LO-IBD, 10 to ≤17 years) IBD according to the age at diagnosis. Patients' data with ulcerative colitis (UC) and Crohn's disease (CD) were compared.
Of 176 patients, 47 (26.7%) were diagnosed with EO-IBD. Patients with early-onset ulcerative colitis (EO-UC) had the highest rate of family history of IBD (17.6%). Pancolitis was the most common form of UC regardless of the age at onset. The rate of moderate-severe disease activity in later-onset UC (62.5%) was higher than in EO-UC (37.5%). A higher rate of extraintestinal manifestations was observed in EO-IBD patients, particularly in EO-UC (38.2%) than in LO-IBD patients. Patients with early-onset CD (EO-CD) had predominantly colonic involvement and nonstricturing, nonpenetrating disease behavior. The rate of perianal disease in patients with later-onset CD (LO-CD) (64.5%) was noticeably higher than those with EO-CD (23%).
Our results suggest that patients with EO-UC represented a distinct phenotype with a mild disease activity, high rate of extraintestinal symptoms, and a high proportion of family history. The analysis of our IBD cohort also demonstrated remarkably high rate of perianal disease, particularly in patients with LO-CD.
目前尚不清楚小儿炎症性肠病（IBD）在东西方国家之间的特征是否存在差异。本研究旨在根据诊断时的年龄，分析土耳其小儿 IBD 的特征。
对在我院接受治疗的 176 名 IBD 患儿的资料进行分析。根据诊断时的年龄，将患者分为早发型（EO-IBD，发病年龄为 2 至＜10 岁）和晚发型（LO-IBD，发病年龄为 10 至≤17 岁）IBD。比较溃疡性结肠炎（UC）和克罗恩病（CD）患者的资料。
176 例患者中，47 例（26.7%）诊断为早发型 IBD。早发型溃疡性结肠炎（EO-UC）患者的 IBD 家族史发生率最高（17.6%）。无论发病年龄如何，全结肠炎均为 UC 最常见的类型。晚发型 UC 中中重度疾病活动的发生率（62.5%）高于早发型 UC（37.5%）。早发型 IBD 患者的肠外表现发生率较高，尤其是早发型 UC（38.2%）患者高于晚发型 IBD 患者。早发型 CD（EO-CD）患者主要累及结肠，且表现为非狭窄、非穿透性疾病行为。晚发型 CD（LO-CD）患者的肛周疾病发生率（64.5%）明显高于 EO-CD 患者（23%）。
我们的研究结果表明，EO-UC 患者具有独特的表型，表现为疾病活动度较轻、肠外症状发生率高、家族史比例高。对本 IBD 队列的分析还表明，肛周疾病的发生率很高，尤其是 LO-CD 患者。
