Extraintestinal Manifestations of Pediatric Inflammatory Bowel Disease: Prevalence, Presentation, and Anti-TNF Treatment

There is a paucity of data on extraintestinal manifestations (EIM) and their treatment in pediatric patients with inflammatory bowel disease (IBD). Since 2008, the Pediatric Swiss IBD Cohort Study has collected data on the pediatric IBD population in Switzerland. Data on 329 patients were analyzed r...

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Veröffentlicht in:Journal of pediatric gastroenterology and nutrition Jg. 65; H. 2; S. 200
Hauptverfasser: Greuter, Thomas, Bertoldo, Fabio, Rechner, Roman, Straumann, Alex, Biedermann, Luc, Zeitz, Jonas, Misselwitz, Benjamin, Scharl, Michael, Rogler, Gerhard, Safroneeva, Ekaterina, Ali, Raja A R, Braegger, Christian, Heyland, Klaas, Mueller, Pascal, Nydegger, Andreas, Petit, Laetitia-Marie, Schibli, Susanne, Furlano, Raoul I, Spalinger, Johannes, Schäppi, Michela, Zamora, Samuel, Froehlich, Florian, Herzog, Denise, Schoepfer, Alain M, Vavricka, Stephan R
Format: Journal Article
Sprache:Englisch
Veröffentlicht: United States 01.08.2017
Schlagworte:
Adolescent
Anti-Inflammatory Agents - therapeutic use
Child
Child, Preschool
Cholangitis, Sclerosing - diagnosis
Cholangitis, Sclerosing - drug therapy
Cholangitis, Sclerosing - epidemiology
Cholangitis, Sclerosing - etiology
Colitis, Ulcerative - complications
Colitis, Ulcerative - diagnosis
Colitis, Ulcerative - drug therapy
Crohn Disease - complications
Crohn Disease - diagnosis
Crohn Disease - drug therapy
Female
Follow-Up Studies
Humans
Infant
Infant, Newborn
Joint Diseases - diagnosis
Joint Diseases - drug therapy
Joint Diseases - epidemiology
Joint Diseases - etiology
Logistic Models
Male
Prevalence
Retrospective Studies
Skin Diseases - diagnosis
Skin Diseases - drug therapy
Skin Diseases - epidemiology
Skin Diseases - etiology
Tumor Necrosis Factor-alpha - antagonists & inhibitors
Uveitis - diagnosis
Uveitis - drug therapy
Uveitis - epidemiology
Uveitis - etiology
ISSN:1536-4801, 1536-4801
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Zusammenfassung:There is a paucity of data on extraintestinal manifestations (EIM) and their treatment in pediatric patients with inflammatory bowel disease (IBD). Since 2008, the Pediatric Swiss IBD Cohort Study has collected data on the pediatric IBD population in Switzerland. Data on 329 patients were analyzed retrospectively. A total of 55 patients (16.7%) experienced 1-4 EIM (39 Crohn disease, 12 ulcerative colitis, and 4 IBD-unclassified patients). At IBD onset, presence of EIM was more frequent than in the adult population (8.5% vs 5.0%, P = 0.014). EIM were more frequent in Crohn disease when compared to ulcerative colitis/IBD-unclassified (22.5% vs 10.3%, P = 0.003). The most prevalent EIM were peripheral arthritis (26/329, 7.9%) and aphthous stomatitis (24/329, 7.3%). Approximately 27.6% of all EIM appeared before IBD diagnosis. Median time between IBD diagnosis and occurrence of first EIM was 1 month (-37.5-149.0). Thirty-one of the 55 patients (56.4%) were treated with 1 or more anti-tumor necrosis factor (TNF) agents. IBD patients with EIM were more likely to be treated with anti-TNF compared to those without (56.4% vs 35.0%, P = 0.003). Response rates to anti-TNF depended on underlying EIM and were best for peripheral arthritis (61.5%) and uveitis (66.7%). In a cohort of pediatric patients with IBD, EIM were frequently encountered. In up to 30%, EIM appeared before IBD diagnosis. Knowledge of these findings may translate into an increased awareness of underlying IBD, thereby decreasing diagnostic delay. Anti-TNF for the treatment of certain EIM is effective, although a substantial proportion of new EIM may present despite ongoing anti-TNF therapy.
Bibliographie:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
ISSN:1536-4801
1536-4801
DOI:10.1097/MPG.0000000000001455