Age and family history at presentation of pediatric inflammatory bowel disease.
OBJECTIVE
Young children are thought to be a unique subset of pediatric patients with inflammatory bowel disease (IBD). The authors' objective was to evaluate the differences in initial clinical presentation of young and older children with IBD and to determine whether a positive family history of IBD is associated with the age of presentation.


METHODS
The authors reviewed the records of all patients with new diagnoses of Crohn disease (CD) and ulcerative colitis (UC) who presented between July 1996 and July 1999. Initial evaluation included assessment of growth parameters and laboratory values (hemoglobin concentration, platelet count, erythrocyte sedimentation rate, and serum albumin). Inquiry regarding a family history of IBD was made in every patient.


RESULTS
There were 153 patients with new diagnoses (82 with CD and 71 with UC), with a mean age of 11.9 years (range, 16 months-18 years). The children with CD had a higher sedimentation rate and platelet count and a lower mean hemoglobin concentration and serum albumin at presentation than did children with UC. Body mass index (BMI) was significantly lower in patients with newly diagnosed CD than in those with UC. The only significant laboratory differences between patients younger than 11 years and those 11 years or older was a higher mean platelet count in patients with CD who were younger than 11 years. Of the younger patients with CD, 41.7% had a positive family history of IBD, which was significantly greater that that found in the older patients with CD.


CONCLUSIONS
Except for higher platelet counts, a lower BMI, and a higher frequency of positive family history in young children with CD, there were no significant differences in the presentation of young children with IBD compared with older children.
Division of Pediatric Gastroenterology, Schneider Children's Hospital, North Shore-Long Island Jewish Health System, Albert Einstein College of Medicine, New Hyde Park, New York 11040, USA. weinstei@lij.edu
Toba A
TA
Weinstein
Mindy
M
Levine
Michael J
MJ
Pettei
David M
DM
Gold
Bradley H
BH
Kessler
Jeremiah J
JJ
Levine
D000293:Adolescent; D000375:Aging; D001799:Blood Sedimentation; D015992:Body Mass Index; D001835:Body Weight; D002648:Child; D002675:Child, Preschool; D003093:Colitis, Ulcerative / Q000175:diagnosis / Q000235:genetics; D003424:Crohn Disease / Q000175:diagnosis / Q000235:genetics; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007223:Infant; D015212:Inflammatory Bowel Diseases / Q000175:diagnosis* / Q000235:genetics*; D008297:Male; D010976:Platelet Count; D012189:Retrospective Studies; D012709:Serum Albumin / Q000032:analysis
D006454:Hemoglobins; D012709:Serum Albumin