title: Difference between early onset and late-onset pediatric ulcerative colitis.
abstract: BACKGROUND
  Early onset pediatric ulcerative colitis (EO-UC) is distinguished from late-onset pediatric ulcerative colitis (LO-UC) by the effects of genetic predisposition, but there have been few reports on the clinical features of EO-UC in Asia.
  
  
  METHODS
  To describe and compare the presentation and disease course of EO-UC (age range, 0-7 years) with those of LO-UC (age range, 8-15 years), we retrospectively analyzed 63 children with UC who had been diagnosed between January 2004 and March 2014 at Saitama Children's Medical Center in Japan.
  
  
  RESULTS
  Ten patients (16%) had EO-UC, and 53 (84%) had LO-UC. All patients in the EO-UC group and 70% in the LO-UC group had pancolitis (P = 0.05). The period from onset to diagnosis was 9.0 ± 14.1 months for EO-UC and 2.6 ± 3.5 months for LO-UC (P < 0.01). The prevalence of extra-intestinal complications at diagnosis was significantly higher for EO-UC than for LO-UC (50% vs 11%, respectively; P < 0.01). There were no significant differences in the use of corticosteroids, immunomodulators, immunosuppressants, or surgical risk between the groups but, in the EO-UC group, only one patient was treated with cytapheresis and none was treated with anti-tumor necrosis factor (TNF-α) antibodies.
  
  
  CONCLUSIONS
  The EO-UC group had a higher incidence of pancolitis, longer diagnostic delay, and more extra-intestinal manifestations than the LO-UC group. Diagnosis and treatment may therefore be slightly more difficult for EO-UC than for LO-UC.
authors.affiliation: Division of General Pediatrics, Saitama Children's Medical Center, Saitama, Japan. nambee1231@gmail.com.
authors.forename: Ryusuke
authors.initials: R
authors.lastname: Nambu
authors.affiliation: Division of General Pediatrics, Saitama Children's Medical Center, Saitama, Japan.
authors.forename: Shin-Ichiro
authors.initials: S
authors.lastname: Hagiwara
authors.affiliation: Division of General Pediatrics, Saitama Children's Medical Center, Saitama, Japan.
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Kubota
authors.affiliation: Division of General Pediatrics, Saitama Children's Medical Center, Saitama, Japan.
authors.forename: Seiichi
authors.initials: S
authors.lastname: Kagimoto
mesh_terms: D000293:Adolescent; D017668:Age of Onset; D002648:Child; D002675:Child, Preschool; D003093:Colitis, Ulcerative / Q000175:diagnosis / Q000453:epidemiology*; D057210:Delayed Diagnosis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007564:Japan / Q000453:epidemiology; D008297:Male; D015995:Prevalence; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013997:Time Factors
keywords: children; early onset; infantile inflammatory bowel disease; ulcerative colitis