Clinical Features and Outcomes of Very-Early-Onset Inflammatory Bowel Disease in Brazilian Children

JPGN Reports · 4 authors, 2 centres

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A retrospective single-center study analyzed 20 Brazilian children under 6 years of age diagnosed with very-early-onset inflammatory bowel disease (VEO-IBD), comprising 13 with ulcerative colitis (UC) and 7 with Crohn disease (CD). The study found that children with CD were diagnosed significantly earlier than those with UC. At presentation, CD was associated with more severe nutritional impairment, including lower weight z-scores and higher rates of hypoalbuminemia. Treatment required systemic corticosteroids and high rates of immunosuppressant therapy.

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cohort

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pediatrics

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ORIGINAL PAPER

PMC10191598

Clinical Features and Outcomes of Very-Early-Onset Inflammatory Bowel Disease in Brazilian Children

JPGN Reports

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ABSTRACT

Abstract We report on 20 Brazilian children under 6 years of age with very-early-onset inflammatory bowel disease naive to treatment. The clinical, laboratory, and histopathologic findings at diagnosis and outcomes were reviewed: 13 had ulcerative colitis (UC) and 7 had Crohn disease (CD). The final diagnostic pattern was as follows: 4 children had neonatal-onset (1 UC and 3 CD), 8 had infantile subtype (4 UC and 4 CD), and 8 had UC beyond the neonatal and infantile period. Both forms of inflammatory bowel disease were severe and extensive at diagnosis, with a high prevalence of bloody diarrhea, reflecting the colonic location of the disease. UC was predominantly pancolonic, CD was isolated in the colon and associated with perianal disease. Children with CD were younger than those with UC, were significantly more nutritionally impaired, and had more complications. This study shows that very-early-onset inflammatory bowel disease has an aggressive clinical course with 2 distinct phenotypes, UC and CD, with differences in severity, clinical behavior, and inflammatory pattern but with a preponderance of colonic involvement in both types. Keywords: inflammatory bowel disease, ulcerative colitis, Crohn disease, pediatric, very early onset

CITATION EXPORT

Debora Avellaneda Penatti, Nilton Carlos Machado, Mary Assis Carvalho et al.. Clinical Features and Outcomes of Very-Early-Onset Inflammatory Bowel Disease in Brazilian Children. JPGN Reports. (2020). https://doi.org/10.1097/PG9.0000000000000032

AUTHORS

4 · 2 CENTRES

Debora Avellaneda Penatti, Nilton Carlos Machado, Mary Assis Carvalho, Maria Aparecida Marchesan Rodrigues

From the *Division of Pediatric Gastroenterology and Nutrition, Department of Pediatrics, Botucatu Medical School, Unesp-Sao Paulo State University, Botucatu, São Paulo, Brazil
†Department of Pathology, Botucatu Medical School, Unesp-Sao Paulo State University, Botucatu, São Paulo, Brazil.