title: Ulcerative proctitis is a frequent location of paediatric-onset UC and not a minor disease: a population-based study.
abstract: Natural history of paediatric-onset ulcerative proctitis (UP) is poorly described. Our aim was to describe the phenotype and disease course of incident UP in a population-based study of paediatric-onset UC.
  
  
  
  All patients with UC diagnosed <17 years from 1988 to 2004, and followed during >2 years have been extracted from a population-based registry. UC location was defined according to the Paris classification. Cumulative risks for use of immunosuppressants (IS), anti-tumour necrosis factor alpha (TNF-α) therapy, colonic extension and colectomy were described using Kaplan-Meier method. Risk factors for colonic extension were assessed using Cox proportional hazards models.
  
  
  
  158 patients with paediatric-onset UC (91 females) with a median age at diagnosis of 14.5 years (Q1: 11.4-Q3: 16.1) have been identified and followed during a median of 11.4 years (8.2-15.8). Among them, 25% had UP (E1) at diagnosis and 49% of them presented a colonic extension at maximal follow-up. In these children, the cumulative risk for colonic extension was 10% at 1 year, 45% at 5 years and 52% at 10 years. No parameter at diagnosis was associated with colonic extension in the UP (E1 group). IS use was significantly lower in patients with UP than in those with E2, E3 or E4 location (p=0.049). For the UP cohort, the cumulative risk for colectomy was 3% at 1 year, 10% at 5 years, 13% at 10 years and 13% at 15 years. Risks for colonic extension, treatment with anti-TNF-α and colectomy did not differ between the E1 group and the E2-E3-E4 group.
  
  
  
  UP is frequent in paediatric-onset UC and should not be considered as a minor disease. Compared with more extensive UC locations, risks for colonic extension, anti-TNF-α therapy and colectomy were similar in UP, whereas the risk for use of IM was lower.
authors.affiliation: Gastroenterology, Hepatology and Nutrition Unit, Department of Pediatrics, Lille University and Hospital, France et Univ. Lille CHU Lille, Lille, France.
authors.forename: A
authors.initials: A
authors.lastname: Hochart
authors.affiliation: Lille Inflammation Research International Center LIRIC-UMR 995 Team 5, Inserm/Université Lille 2/CHRU de Lille, Lille, France.|Public Health, Epidemiology and Economic Health, Registre Epimad, Maison Régionale de la Recherche Clinique, Centre Hospitalier Universitaire Régional, Lille, Cedex, France.
authors.forename: C
authors.initials: C
authors.lastname: Gower-Rousseau
authors.affiliation: Lille Inflammation Research International Center LIRIC-UMR 995 Team 5, Inserm/Université Lille 2/CHRU de Lille, Lille, France.|Public Health, Epidemiology and Economic Health, Registre Epimad, Maison Régionale de la Recherche Clinique, Centre Hospitalier Universitaire Régional, Lille, Cedex, France.
authors.forename: H
authors.initials: H
authors.lastname: Sarter
authors.affiliation: Lille Inflammation Research International Center LIRIC-UMR 995 Team 5, Inserm/Université Lille 2/CHRU de Lille, Lille, France.|Gastroenterology Unit, Epimad Registry, CHU Amiens Sud, Avenue Laennec-Salouel, Amiens University Hospital, France.
authors.forename: M
authors.initials: M
authors.lastname: Fumery
authors.affiliation: Gastroenterology, Hepatology and Nutrition Unit, Department of Pediatrics, Lille University and Hospital, France et Univ. Lille CHU Lille, Lille, France.|Lille Inflammation Research International Center LIRIC-UMR 995 Team 5, Inserm/Université Lille 2/CHRU de Lille, Lille, France.
authors.forename: D
authors.initials: D
authors.lastname: Ley
authors.affiliation: Gastroenterology, Hepatology and Nutrition Unit, Department of Pediatrics, Saint Vincent de Paul Hospital and Lille Catholic University, Lille, France.
authors.forename: C
authors.initials: C
authors.lastname: Spyckerelle
authors.affiliation: Hepato-Gastroenterology Unit, Inserm, U954, Nancy University Hospital, France.
authors.forename: L
authors.initials: L
authors.lastname: Peyrin-Biroulet
authors.affiliation: Hepato-Gastroenterology Unit, Epimad Registry, General Hospital, Seclin, France.
authors.forename: J-E
authors.initials: JE
authors.lastname: Laberenne
authors.affiliation: Department of Biostatistics, EA 2694, Lille University Hospital, France.
authors.forename: F
authors.initials: F
authors.lastname: Vasseur
authors.affiliation: Gastroenterology Unit, Epimad Registry, Hôpital Charles Nicolle, Rouen University Hospital, Rouen, France.
authors.forename: G
authors.initials: G
authors.lastname: Savoye
authors.affiliation: Gastroenterology, Hepatology and Nutrition Unit, Department of Pediatrics, Lille University and Hospital, France et Univ. Lille CHU Lille, Lille, France.|Lille Inflammation Research International Center LIRIC-UMR 995 Team 5, Inserm/Université Lille 2/CHRU de Lille, Lille, France.
authors.forename: D
authors.initials: D
authors.lastname: Turck
mesh_terms: D000293:Adolescent; D002648:Child; D003082:Colectomy; D003093:Colitis, Ulcerative / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D053208:Kaplan-Meier Estimate; D008297:Male; D010641:Phenotype; D011349:Proctitis / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D011379:Prognosis; D016016:Proportional Hazards Models; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D007166:Immunosuppressive Agents
keywords: EPIDEMIOLOGY; PAEDIATRIC GASTROENTEROLOGY; ULCERATIVE COLITIS