Clinical pattern of early versus late onset inflammatory bowel disease among Egyption chlidren : A single center study / Saeed Sayed Seddek ; Supervised Manal Elsayed Abdelmeguid , Ayman Emil Eskander , Hala Hussien Mansour

Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Pediatrics

Background: The objectives of this single-center study were to compare the clinical phenotypes of Very Early-Onset Inflammatory Bowel Disease (VEO-IBD) < 6yrs with Late -Onset IBD (LO-IBD) 6-14 yrs Methods: This study was conducted at Pediatric Gastroenterology Clinic at Children{u2019}s Hospital, Faculty of Medicine, Cairo University. A retrospective, comparative, descriptive analysis included 197 children aged < 14 years with a confirmed diagnosis of different types of IBD from January 2013 to December 2017. Results: In our study children diagnosed with IBD < 6 years of age have a primarily colonic phenotype compared with children diagnosed at later ages who are more likely to have ileo-colonic disease p=0.002. Although children with VEO-IBD do not necessarily present with greater disease severity compared with the older children. Most clinical features were similar at first presentation in the VEO-UC and LO-UC children, with the exception of abdominal pain, which was significantly less common in the VEO-UC group p=< 0.001 and hematochezia which was significantly more common in the LO-UC group p =0.048. Those presenting as VEO-CD children were more likely to have bloody stools, diarrhea and fever p = (0.013,0.001,0.008) respectively, and less likely to have abdominal pain p = 0.000. Immunological association was significantly more common with VEO-CD children p= 0.035 which may enhance the genetic background of VEO-CD. Conclusions: Our study confirms that children diagnosed with IBD < 6 years of age have a primarily colonic phenotype compared with children diagnosed at later ages(6-14yrs) who are more likely to have ileo-colonic disease

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