Comparison of longstanding pediatric-onset and adult-onset Crohn's disease.
BACKGROUND
Limited information is available on the characteristics of longstanding Crohn's disease with onset in childhood or adolescence.


METHODS
In this retrospective study, 224 patients with pediatric-onset Crohn's disease were compared to a group of patients with disease diagnosed as adults.


RESULTS
More than 50% of the patients in the pediatric-onset group were followed for more than a decade, with a mean follow-up of 12.2 years. There were 96 male (42.9%) and 128 female (57.1%) patients. Most had disease diagnosed in adolescence. The female predominance, similar to adult-onset disease, was noted only among patients with disease diagnosed in adolescence (13-19 years), not in childhood. Disease most often involved both ileum and colon (128 of 224; 57.1%). Isolated ileal or colonic disease was less common. Upper gastrointestinal tract disease was present in 42 of 224 (18.8%) patients. The incidence of strictures (28.6%) and penetrating complications (46.4%) was similar to that of adults followed for the same period of time.


CONCLUSIONS
In pediatric-onset Crohn's disease, female-predominance emerges during adolescence. Pediatric-onset disease is more extensive than adult-onset disease. When followed for an extended period of time, it has high rates of disease complexity, with strictures and penetrating complications similar to adult-onset disease.
Department of Medicine (Gastroenterology), University of British Columbia, Vancouver, BC, Canada.
Hugh J
HJ
Freeman
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D017668:Age of Onset; D002648:Child; D003424:Crohn Disease / Q000145:classification / Q000150:complications / Q000453:epidemiology*; D016208:Databases, Factual; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D017678:Sex Distribution; D013997:Time Factors