Inflammatory bowel disease developing in paediatric and adult age.
OBJECTIVE
In recent decades, there has been a significant increase in the incidence of inflammatory bowel disease (IBD). It has yet to be established whether the manifestations of IBD are similar in paediatric and adult ages. The objective of this study was to compare the phenotypic expression of the disease between patients with childhood-onset IBD and adulthood-onset cases, all afferent to the same clinical centre.


METHODS
Descriptive and multivariate analyses were completed on retrospective and prospective data of paediatric-onset and adult-onset consecutive cases who were diagnosed and followed at the same tertiary referral hospital of the University of Padua, Italy, during a period of 14 years (1994-2008). Paediatric-onset patients were further divided into age brackets (0-5, 6-12, and 13-17 year-olds). Analyses were conducted using the SAS package, version 9.1 (SAS Institute Inc, Cary, NC).


RESULTS
Three hundred twelve patients were analysed. At disease onset, the manifestations which were more frequent among the 133 paediatric patients (50.4% with diagnosis of Crohn disease [CD], 43.6% with ulcerative colitis, and 6% with unclassified IBD) with respect to the adult-onset patients were perianal disease (12.8%) (P < 0.0001) and extraintestinal manifestations (14.3%) (P = 0.043). Among the 179 adult patients (55.3% with diagnosis of ulcerative colitis, 36.3% with CD, and 8.3% with unclassified IBD) instead, severe abdominal pain (P = 0.008), diarrhoea (P = 0.005), and anorexia (P < 0.0001) were more frequently observed. During the follow-up, the presence of extraintestinal manifestations (50.4%) (P = 0.005) and perianal disease (44.8% of the patients with childhood-onset CD) (P = 0.006) was observed more often in the paediatric-onset group.


CONCLUSIONS
In our cases, the phenotypic expression of IBD developing in paediatric age differs from that seen in adults.
Guariso
Graziella
G
Unit of Gastroenterology, Department of Paediatrics, University of Padua, Italy. guariso@pediatria.unipd.it
Gasparetto
Marco
M
Visonà Dalla Pozza
Laura
L
D'Incà
Renata
R
Zancan
Lucia
L
Sturniolo
Giancarlo
G
Brotto
Francesca
F
Facchin
Paola
P
D015746:Abdominal Pain / Q000453:epidemiology / Q000209:etiology; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D017668:Age of Onset; D000855:Anorexia / Q000453:epidemiology / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D015212:Inflammatory Bowel Diseases / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology; D007558:Italy; D008297:Male; D015999:Multivariate Analysis; D055815:Young Adult