title: Pediatric inflammatory bowel disease in Greece: 30-years experience of a single center.
abstract: BACKGROUND
  Significant advances have been made in the care of children with inflammatory bowel disease (IBD). We aimed to describe the trends during the last 3 decades in the clinical presentation, management, and outcome of pediatric IBD at a single center.
  
  
  METHODS
  Medical records of children with IBD referred to a pediatric gastroenterology unit from January 1981 to December 2011 were reviewed retrospectively.
  
  
  RESULTS
  A total of 483 children were diagnosed with IBD, with mean age at diagnosis of 9.6 years (range 6 months - 18 years). Ulcerative colitis (UC) was diagnosed in 267 (55.2%), Crohn's disease (CD) in 167 (34.5%), and IBD unclassified (IBDU) in 49 (10.1%). Children with UC and IBDU were younger than those with CD [mean age at diagnosis 9.2, 8.9, and 10.5 years respectively; P (UC vs. CD)<0.01 and P (IBDU vs. CD)=0.028]. Patients received 5-ASA (96.6%), steroids (77.0%), thiopurines (50.2%), biological agents (14%), and 10% underwent surgical intervention. The cohort was divided into three subgroups according to the date of diagnosis; Group A: 1981-1989, Group B: 1990-1999, and Group C: 2000-2011. During the last two decades a significant increase in CD (Group A 18.5%, Group B 23.8%, Group C 48.8%; P<0.01) compared with the first decade with parallel decrease in UC (Group A 79.6%, Group B 71.9%, Group C 33.2%; P<0.001) was observed.
  
  
  CONCLUSIONS
  Most children received 5-ASA, steroids, and immunomodulators. Patients with UC and IBDU were younger than those with CD. A significant increase in CD with parallel decrease in UC during the last decade was found.
authors.affiliation: First Department of Pediatrics University of Athens (Konstantina Dimakou, Ioanna Pachoula, Ioanna Panayotou, Irini Orfanou, Evagelia Lagona, Eleftheria Roma-Giannikou, George Chouliaras), Athens, Greece.
authors.forename: Konstantina
authors.initials: K
authors.lastname: Dimakou
authors.affiliation: First Department of Pediatrics University of Athens (Konstantina Dimakou, Ioanna Pachoula, Ioanna Panayotou, Irini Orfanou, Evagelia Lagona, Eleftheria Roma-Giannikou, George Chouliaras), Athens, Greece.
authors.forename: Ioanna
authors.initials: I
authors.lastname: Pachoula
authors.affiliation: First Department of Pediatrics University of Athens (Konstantina Dimakou, Ioanna Pachoula, Ioanna Panayotou, Irini Orfanou, Evagelia Lagona, Eleftheria Roma-Giannikou, George Chouliaras), Athens, Greece.
authors.forename: Ioanna
authors.initials: I
authors.lastname: Panayotou
authors.affiliation: Histopathology Department, Aghia Sophia Children's Hospital (Kalliopi Stefanaki), Athens, Greece.
authors.forename: Kalliopi
authors.initials: K
authors.lastname: Stefanaki
authors.affiliation: First Department of Pediatrics University of Athens (Konstantina Dimakou, Ioanna Pachoula, Ioanna Panayotou, Irini Orfanou, Evagelia Lagona, Eleftheria Roma-Giannikou, George Chouliaras), Athens, Greece.
authors.forename: Irini
authors.initials: I
authors.lastname: Orfanou
authors.affiliation: First Department of Pediatrics University of Athens (Konstantina Dimakou, Ioanna Pachoula, Ioanna Panayotou, Irini Orfanou, Evagelia Lagona, Eleftheria Roma-Giannikou, George Chouliaras), Athens, Greece.
authors.forename: Evagelia
authors.initials: E
authors.lastname: Lagona
authors.affiliation: First Department of Pediatrics University of Athens (Konstantina Dimakou, Ioanna Pachoula, Ioanna Panayotou, Irini Orfanou, Evagelia Lagona, Eleftheria Roma-Giannikou, George Chouliaras), Athens, Greece.
authors.forename: Eleftheria
authors.initials: E
authors.lastname: Roma-Giannikou
authors.affiliation: First Department of Pediatrics University of Athens (Konstantina Dimakou, Ioanna Pachoula, Ioanna Panayotou, Irini Orfanou, Evagelia Lagona, Eleftheria Roma-Giannikou, George Chouliaras), Athens, Greece.
authors.forename: George
authors.initials: G
authors.lastname: Chouliaras
keywords: Crohn’s disease; Keywords Ιnflammatory bowel disease; children; treatment; ulcerative colitis; unclassified IBD