title: Presenting features and disease course of pediatric ulcerative colitis.
abstract: Clinical variables and disease course of pediatric ulcerative colitis (UC) have been poorly reported. The aim of this study was to retrospectively describe the phenotype and disease course of pediatric onset UC diagnosed at a tertiary referral Center for Pediatric Gastroenterology.
  
  
  METHODS
  110 patients with a diagnosis of UC were identified at our Department database. Records were reviewed for disease location and behavior at the diagnosis, family history for inflammatory bowel disease, pattern changes at the follow-up, need of surgery and cumulative risk for colectomy.
  
  
  RESULTS
  Thirty-five % of patients had an early-onset disease (0-7 years). At the diagnosis, 29% had proctitis, 22% left-sided colitis, 15% extensive colitis and 34% pancolitis. Fifteen % presented with a rectal sparing, while a patchy colonic inflammation was reported in 18%. Rectal sparing was significantly related to the younger age (p: <0.05). Disease extension at the follow up was reported in 29% of pts. No clinical variables at the diagnosis were related to the subsequent extension of the disease. The cumulative rates of colectomy were 9% at 2 year and 14% at 5 years. An extensive disease as well as acute severe colitis and corticosteroid therapy at the diagnosis were significantly associated with an increased risk of colectomy.
  
  
  CONCLUSIONS
  Pediatric UC is extensive and severe at the diagnosis, with an overall high rate of disease extension at the follow-up. Endoscopic atypical features are common in young children. The colectomy rate is related to the location and severity of the disease at the diagnosis.
authors.affiliation: Pediatric Gastroenterology and Liver Unit, Sapienza University of Rome, Italy. Electronic address: marina.aloi@uniroma1.it.
authors.forename: Marina
authors.initials: M
authors.lastname: Aloi
authors.forename: Giulia
authors.initials: G
authors.lastname: D'Arcangelo
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Pofi
authors.forename: Francesca
authors.initials: F
authors.lastname: Vassallo
authors.forename: Valentina
authors.initials: V
authors.lastname: Rizzo
authors.forename: Federica
authors.initials: F
authors.lastname: Nuti
authors.forename: Giovanni
authors.initials: G
authors.lastname: Di Nardo
authors.forename: Maria
authors.initials: M
authors.lastname: Pierdomenico
authors.forename: Franca
authors.initials: F
authors.lastname: Viola
authors.forename: Salvatore
authors.initials: S
authors.lastname: Cucchiara
mesh_terms: D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage; D017668:Age of Onset; D000704:Analysis of Variance; D001707:Biopsy, Needle; D002648:Child; D002675:Child, Preschool; D003082:Colectomy / Q000379:methods / Q000706:statistics & numerical data*; D003093:Colitis, Ulcerative / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D003131:Combined Modality Therapy; D016001:Confidence Intervals; D016208:Databases, Factual; D018450:Disease Progression; D042241:Early Diagnosis; D016099:Endoscopy, Gastrointestinal / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D007413:Intestinal Mucosa / Q000473:pathology; D008137:Longitudinal Studies; D008297:Male; D016017:Odds Ratio; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones; D007166:Immunosuppressive Agents
keywords: Atypical findings; Children; Disease course; Early-onset; Ulcerative colitis