Incidence rates and disease course of paediatric inflammatory bowel diseases in Western Hungary between 1977 and 2011.
BACKGROUND
Limited data are available on paediatric inflammatory bowel diseases in Eastern Europe. Our aim was to analyse disease characteristics in the population-based Veszprem province database between 1977 and 2011.


METHODS
187 (10.5%, ulcerative colitis/Crohn's disease/undetermined colitis: 88/95/4) out of 1565 incident patients were diagnosed with a paediatric onset in this population-based prospective inception cohort.


RESULTS
The incidence of Crohn's disease and ulcerative colitis increased from 0 and 0.7 in 1977-1981 to 7.2 and 5.2 in 2007-2011 per 100,000 person years. Ileocolonic location (45%) and inflammatory disease behaviour (61%) were most frequent in Crohn's disease, while azathioprine use was frequent (66%) and surgical resection rates were high (33% at 5 years) in cases with paediatric onset. In ulcerative colitis, 34% of patients were diagnosed with extensive disease, with high rates of disease extension (26% and 41% at 5 and 10 years), fulminant episodes (19.3%) and systemic steroid use (52.3%). The cumulative rate of colectomy was low (6.9%).


CONCLUSIONS
The incidence of paediatric inflammatory bowel diseases has rapidly increased in the last three decades in Western Hungary. Ileocolonic disease and a need for azathioprine were characteristic in paediatric Crohn's disease, while paediatric onset ulcerative colitis was characterised by extensive disease and disease extension, while the need for colectomy was low.
1st Department of Medicine, Semmelweis University, Budapest, Hungary.
Barbara D
BD
Lovasz
Department of Medicine, Csolnoky F. Province Hospital, Veszprem, Hungary.
Laszlo
L
Lakatos
Department of Pediatrics, Csolnoky F. Province Hospital, Veszprem, Hungary.
Agnes
A
Horvath
Department of Medicine, Csolnoky F. Province Hospital, Veszprem, Hungary.
Tunde
T
Pandur
Department of Medicine, Csolnoky F. Province Hospital, Veszprem, Hungary.
Zsuzsanna
Z
Erdelyi
Department of Medicine, Grof Eszterhazy Hospital, Papa, Hungary.
Mihaly
M
Balogh
Department of Medicine, Municipal Hospital, Tapolca, Hungary.
Istvan
I
Szipocs
1st Department of Medicine, Semmelweis University, Budapest, Hungary; Department of Medicine, Csolnoky F. Province Hospital, Veszprem, Hungary.
Zsuzsanna
Z
Vegh
1st Department of Pediatrics, Semmelweis University, Budapest, Hungary.
Gabor
G
Veres
1st Department of Pediatrics, Semmelweis University, Budapest, Hungary.
Katalin E
KE
Müller
1st Department of Medicine, Semmelweis University, Budapest, Hungary.
Petra A
PA
Golovics
1st Department of Medicine, Semmelweis University, Budapest, Hungary.
Lajos S
LS
Kiss
1st Department of Medicine, Semmelweis University, Budapest, Hungary.
Michael D
MD
Mandel
1st Department of Medicine, Semmelweis University, Budapest, Hungary. Electronic address: lakatos.peter_laszlo@med.semmelweis-univ.hu.
Peter L
PL
Lakatos
D000293:Adolescent; D000367:Age Factors; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001379:Azathioprine / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003082:Colectomy / Q000706:statistics & numerical data; D003093:Colitis, Ulcerative / Q000453:epidemiology* / Q000628:therapy; D003424:Crohn Disease / Q000453:epidemiology* / Q000628:therapy; D005260:Female; D006801:Humans; D006814:Hungary / Q000453:epidemiology; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010641:Phenotype; D012720:Severity of Illness Index; D012737:Sex Factors; D013256:Steroids / Q000627:therapeutic use
D000893:Anti-Inflammatory Agents; D007166:Immunosuppressive Agents; D013256:Steroids; D001379:Azathioprine
Crohn's disease; Disease course; Disease phenotype; Incidence; Paediatric; Ulcerative colitis