title: Baseline Characteristics and Disease Phenotype in Inflammatory Bowel Disease.
abstract: OBJECTIVE
  Predicting short-term relapses and long-term prognosis is of utmost importance in paediatric inflammatory bowel disease (IBD). Our aim was to investigate the short-term disease outcome and medication during the first year in a paediatric incident cohort from Hungary. In addition, association laboratory markers and disease activity indices with short-term disease outcome and medication were analysed.
  
  
  METHODS
  From January 1, 2008 to December 31, 2010, demographic data and clinical characteristics of newly diagnosed paediatric patients with IBD < 18 years of age were prospectively recorded.
  
  
  RESULTS
  A total of 420 patients were identified (Crohn disease [CD] 266 and ulcerative colitis [UC] 124). Initially, 48% (124/256) of the patients with CD had moderate-to-severe disease (Pediatric Crohn's Disease Activity Index [PCDAI] > 31), and this rate decreased to 2.1% at 1-year follow-up. Proportion of patients with UC with moderate-to-severe disease (Pediatric Ulcerative Colitis Activity Index > 35) at diagnosis declined from 57.5% (69/120) to 6.8% at 1-year follow-up. Terminal ileal involvement correlated with higher initial C-reactive protein (CRP) (P = 0.021) and initial PCDAI (P = 0.026). In UC, elevated CRP (P = 0.002) was associated with disease extension. CRP and PCDAI at diagnosis were associated with the need for immunomodulators at 1 year in children with CD. Initial CRP was also associated with the need for immunomodulators in patients with UC at 1-year follow-up.
  
  
  CONCLUSIONS
  At diagnosis, half of the patients with IBD had moderate-to-severe disease, and this rate decreased to <10% after 1 year. Initial CRP and PCDAI were related to the need for aggressive therapy in CD.
authors.affiliation: *First Department of Pediatrics †First Department of Medicine, Semmelweis University ‡Heim-Madarász Hospital, Budapest §Department of Pediatrics, Szent-Györgyi Albert University, Szeged ||Department of Pediatrics, Clinical Center, University of Debrecen, Debrecen ¶Department of Pediatrics, University of Pécs, Pécs #Balassa Hospital, Szekszard **Institute of Internal Medicine, Department of Gastroenterology, University of Debrecen, Clinical Center, Debrecen ††BAZ County Hospital, Miskolc ‡‡Csolnoky Hospital, Veszprém §§Josa Hospital, Nyíregyháza ||||Petz County Hospital, Győr, Hungary.
authors.forename: Katalin E
authors.initials: KE
authors.lastname: Müller
authors.forename: Peter L
authors.initials: PL
authors.lastname: Lakatos
authors.forename: Judit B
authors.initials: JB
authors.lastname: Kovacs
authors.forename: Andras
authors.initials: A
authors.lastname: Arato
authors.forename: Agnes
authors.initials: A
authors.lastname: Varkonyi
authors.forename: Eva
authors.initials: E
authors.lastname: Nemes
authors.forename: Andras
authors.initials: A
authors.lastname: Tarnok
authors.forename: Gergely
authors.initials: G
authors.lastname: Toth
authors.forename: Maria
authors.initials: M
authors.lastname: Papp
authors.forename: Eniko
authors.initials: E
authors.lastname: Solyom
authors.forename: Agnes
authors.initials: A
authors.lastname: Horvath
authors.forename: Ildiko
authors.initials: I
authors.lastname: Guthy
authors.forename: Marta
authors.initials: M
authors.lastname: Kovacs
authors.forename: Gabor
authors.initials: G
authors.lastname: Veres
mesh_terms: D000293:Adolescent; D002097:C-Reactive Protein / Q000032:analysis; D002648:Child; D003093:Colitis, Ulcerative / Q000097:blood / Q000188:drug therapy / Q000473:pathology*; D003424:Crohn Disease / Q000097:blood / Q000188:drug therapy / Q000473:pathology*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007082:Ileum / Q000473:pathology; D007155:Immunologic Factors / Q000627:therapeutic use; D008297:Male; D010641:Phenotype; D011379:Prognosis; D011446:Prospective Studies; D012189:Retrospective Studies; D012720:Severity of Illness Index
chemical_list: D007155:Immunologic Factors; D002097:C-Reactive Protein