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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Vydáno v:	Journal of pediatric gastroenterology and nutrition Ročník 65; číslo 2; s. 200
Hlavní autoři:	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
Médium:	Journal Article
Jazyk:	angličtina
Vydáno:	United States 01.08.2017
Témata:	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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Shrnutí:	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.
Bibliografie:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1536-4801 1536-4801
DOI:	10.1097/MPG.0000000000001455