Bincy P Abraham1, Seema Mehta, Hashem B El-Serag. 1. Michael E. DeBakey Veterans Affairs Medical Center, Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA. bincya@bcm.edu
Abstract
BACKGROUND/AIMS: There has been no systematic review of natural history studies of pediatric-onset inflammatory bowel disease (IBD). We conducted a systematic review focused on understanding the long-term risks of growth failure, disease reclassification and extension, hospitalizations, cancer and death among patients with childhood IBD. METHODS: PubMed searches and subsequent data abstraction were performed by 2 independent investigators. Studies published full in english with a 5-year minimum average follow-up in at least 30 patients with IBD onset before age 18 years. RESULTS: We evaluated 41 total studies (only 2 population-based studies) with 3505 Crohn's disease (CD) patients, 2071 ulcerative colitis (UC) patients, and 461 indeterminate colitis (IC). Growth failure was reported in CD (10% and 56%) more often than UC (0% to 10%) or non-IBD controls. Improvements in growth occurred after surgical resection in patients with CD. There was an increase in disease reclassification over time from UC and indeterminate colitis diagnosis to CD diagnosis. Patients with CD had higher number of hospitalizations and hospital days per year in comparison with UC patients in most studies. The reported surgery rates in CD ranged between 10% and 72%; the colectomy rates in UC ranged between 0% and 50%. Cancers were reported in 6 CD patients during a total 18,270 patient-years (PY) follow-up, and 8 UC patients in 18,115 PY. Deaths directly related to IBD were 63 during 39,719 PY. CONCLUSIONS: Childhood-onset IBD patients had growth failure reported in patients with CD more often than those with UC, had a reclassification of disease type to CD over time. Higher rates of surgery and hospitalizations were found with CD than with UC. The risk of cancer and death is low in this population.
BACKGROUND/AIMS: There has been no systematic review of natural history studies of pediatric-onset inflammatory bowel disease (IBD). We conducted a systematic review focused on understanding the long-term risks of growth failure, disease reclassification and extension, hospitalizations, cancer and death among patients with childhood IBD. METHODS: PubMed searches and subsequent data abstraction were performed by 2 independent investigators. Studies published full in english with a 5-year minimum average follow-up in at least 30 patients with IBD onset before age 18 years. RESULTS: We evaluated 41 total studies (only 2 population-based studies) with 3505 Crohn's disease (CD) patients, 2071 ulcerative colitis (UC) patients, and 461 indeterminate colitis (IC). Growth failure was reported in CD (10% and 56%) more often than UC (0% to 10%) or non-IBD controls. Improvements in growth occurred after surgical resection in patients with CD. There was an increase in disease reclassification over time from UC and indeterminate colitis diagnosis to CD diagnosis. Patients with CD had higher number of hospitalizations and hospital days per year in comparison with UC patients in most studies. The reported surgery rates in CD ranged between 10% and 72%; the colectomy rates in UC ranged between 0% and 50%. Cancers were reported in 6 CDpatients during a total 18,270 patient-years (PY) follow-up, and 8 UC patients in 18,115 PY. Deaths directly related to IBD were 63 during 39,719 PY. CONCLUSIONS: Childhood-onset IBD patients had growth failure reported in patients with CD more often than those with UC, had a reclassification of disease type to CD over time. Higher rates of surgery and hospitalizations were found with CD than with UC. The risk of cancer and death is low in this population.
Authors: Ryan S Carvalho; Vivian Abadom; Harrison P Dilworth; Richard Thompson; Maria Oliva-Hemker; Carmen Cuffari Journal: Inflamm Bowel Dis Date: 2006-04 Impact factor: 5.325
Authors: Neera Gupta; Stanley A Cohen; Alan G Bostrom; Barbara S Kirschner; Robert N Baldassano; Harland S Winter; George D Ferry; Terry Smith; Oren Abramson; Benjamin D Gold; Melvin B Heyman Journal: Gastroenterology Date: 2006-04 Impact factor: 22.682
Authors: Gwenola Vernier-Massouille; Mamadou Balde; Julia Salleron; Dominique Turck; Jean Louis Dupas; Olivier Mouterde; Véronique Merle; Jean Louis Salomez; Julien Branche; Raymond Marti; Eric Lerebours; Antoine Cortot; Corinne Gower-Rousseau; Jean Frédéric Colombel Journal: Gastroenterology Date: 2008-07-03 Impact factor: 22.682
Authors: Troy A Markel; Derek C Lou; Marian Pfefferkorn; L R Scherer; Karen West; Thomas Rouse; Scott Engum; Alan Ladd; Frederick J Rescorla; Deborah F Billmire Journal: Surgery Date: 2008-10 Impact factor: 3.982
Authors: Mark D DeBoer; Meena Thayu; Lindsay M Griffin; Robert N Baldassano; Lee A Denson; Babette S Zemel; Michelle R Denburg; Hannah E Agard; Rita Herskovitz; Jin Long; Mary B Leonard Journal: J Pediatr Date: 2016-02-09 Impact factor: 4.406
Authors: Silvia Ghione; Hélène Sarter; Mathurin Fumery; Laura Armengol-Debeir; Guillaume Savoye; Delphine Ley; Claire Spyckerelle; Benjamin Pariente; Laurent Peyrin-Biroulet; Dominique Turck; Corinne Gower-Rousseau; J M Andre; M Antonietti; A Aouakli; A Armand; I Aroichane; F Assi; J P Aubet; E Auxenfants; F Ayafi-Ramelot; D Bankovski; B Barbry; N Bardoux; P Baron; A Baudet; B Bazin; A Bebahani; J P Becqwort; V Benet; H Benali; C Benguigui; Ben E Soussan; A Bental; I Berkelmans; J Bernet; K Bernou; C Bernou-Dron; P Bertot; N Bertiaux-Vandaële; V Bertrand; E Billoud; N Biron; B Bismuth; M Bleuet; F Blondel; V Blondin; P Bohon; E Boniface; P Bonnière; E Bonvarlet; P Bonvarlet; A Boruchowicz; R Bostvironnois; M Boualit; B Bouche; C Boudaillez; C Bourgeaux; M Bourgeois; A Bourguet; A Bourienne; J Branche; G Bray; F Brazier; P Breban; H Brihier; V Brung-Lefebvre; P Bulois; P Burgiere; J Butel; J Y Canva; V Canva-Delcambre; J P Capron; F Cardot; P Carpentier; E Cartier; J F Cassar; M Cassagnou; J F Castex; P Catala; S Cattan; S Catteau; B Caujolle; G Cayron; C Chandelier; M Chantre; J Charles; T Charneau; M Chavance-Thelu; D Chirita; A Choteau; J F Claerbout; P Y Clergue; H Coevoet; G Cohen; R Collet; J F Colombel; S Coopman; J Corvisart; A Cortot; F Couttenier; J F Crinquette; V Crombe; I Dadamessi; V Dapvril; T Davion; S Dautreme; J Debas; N Degrave; F Dehont; C Delatre; R Delcenserie; O Delette; T Delgrange; L Delhoustal; J S Delmotte; S Demmane; G Deregnaucourt; P Descombes; J P Desechalliers; P Desmet; P Desreumaux; G Desseaux; P Desurmont; A Devienne; E Devouge; M Devred; A Devroux; A Dewailly; S Dharancy; A Di Fiore; D Djeddi; R Djedir; M L Dreher-Duwat; R Dubois; C Dubuque; P Ducatillon; J Duclay; B Ducrocq; F Ducrot; P Ducrotte; A Dufilho; C Duhamel; D Dujardin; C Dumant-Forest; J L Dupas; F Dupont; Y Duranton; A Duriez; K El Achkar; M El Farisi; C Elie; M C Elie-Legrand; A Elkhaki; M Eoche; D Evrard; J P Evrard; A Fatome; B Filoche; L Finet; M Flahaut; C Flamme; D Foissey; P Fournier; M C Foutrein-Comes; P Foutrein; D Fremond; T Frere; M Fumery; P Gallet; C Gamblin; P S Ganga-Zandzou; R Gérard; G Geslin; Y Gheyssens; N Ghossini; S Ghrib; T Gilbert; B Gillet; D Godard; P Godard; J M Godchaux; R Godchaux; G Goegebeur; O Goria; F Gottrand; P Gower; B Grandmaison; M Groux; C Guedon; J F Guillard; L Guillem; F Guillemot; D Guimber; B Haddouche; S Hakim; D Hanon; V Hautefeuille; P Heckestweiller; G Hecquet; J P Hedde; H Hellal; P E Henneresse; B Heyman; M Heraud; S Herve; P Hochain; L Houssin-Bailly; P Houcke; B Huguenin; S Iobagiu; A Ivanovic; I Iwanicki-Caron; E Janicki; M Jarry; J Jeu; J P Joly; C Jonas; F Katherin; A Kerleveo; A Khachfe; A Kiriakos; J Kiriakos; O Klein; M Kohut; R Kornhauser; D Koutsomanis; J E Laberenne; G Laffineur; M Lagarde; P Lannoy; J Lapchin; M Lapprand; D Laude; R Leblanc; P Lecieux; N Leclerc; C Le Couteulx; J Ledent; J Lefebvre; P Lefiliatre; C Legrand; A Le Grix; P Lelong; B Leluyer; C Lenaerts; L Lepileur; A Leplat; E Lepoutre-Dujardin; H Leroi; M Y Leroy; J P Lesage; X Lesage; J Lesage; I Lescanne-Darchis; J Lescut; D Lescut; B Leurent; P Levy; M Lhermie; A Lion; B Lisambert; F Loire; S Louf; A Louvet; M Luciani; D Lucidarme; J Lugand; O Macaigne; D Maetz; D Maillard; H Mancheron; O Manolache; A B Marks-Brunel; R Marti; F Martin; G Martin; E Marzloff; P Mathurin; J Mauillon; V Maunoury; J L Maupas; B Mesnard; P Metayer; L Methari; B Meurisse; F Meurisse; L Michaud; X Mirmaran; P Modaine; A Monthe; L Morel; P E Mortier; E Moulin; O Mouterde; J Mudry; M Nachury; NʼGuyen E Khac; B Notteghem; V Ollevier; A Ostyn; A Ouraghi; D Ouvry; B Paillot; N Panien-Claudot; C Paoletti; A Papazian; B Parent; B Pariente; J C Paris; P Patrier; L Paupart; B Pauwels; M Pauwels; R Petit; M Piat; S Piotte; C Plane; B Plouvier; E Pollet; P Pommelet; D Pop; C Pordes; G Pouchain; P Prades; A Prevost; J C Prevost; B Quesnel; A M Queuniet; J F Quinton; A Rabache; P Rabelle; G Raclot; S Ratajczyk; D Rault; V Razemon; N Reix; M Revillon; C Richez; P Robinson; J Rodriguez; J Roger; J M Roux; A Rudelli; A Saber; G Savoye; P Schlosseberg; M Segrestin; D Seguy; M Serin; A Seryer; F Sevenet; N Shekh; J Silvie; V Simon; C Spyckerelle; N Talbodec; A Techy; J L Thelu; A Thevenin; H Thiebault; J Thomas; J M Thorel; G Tielman; M Tode; J Toisin; J Tonnel; J Y Touchais; Y Touze; J L Tranvouez; C Triplet; D Turck; S Uhlen; E Vaillant; C Valmage; D Vanco; H Vandamme; E Vanderbecq; Vander E Eecken; P Vandermolen; P Vandevenne; L Vandeville; A Vandewalle; C Vandewalle; P Vaneslander; J P Vanhoove; A Vanrenterghem; P Varlet; I Vasies; G Verbiese; G Vernier-Massouille; P Vermelle; C Verne; P Vezilier-Cocq; B Vigneron; M Vincendet; J Viot; Y M Voiment; A Wacrenier; L Waeghemaecker; J Y Wallez; M Wantiez; F Wartel; J Weber; J L Willocquet; N Wizla; E Wolschies; A Zalar; B Zaouri; A Zellweger; C Ziade Journal: Am J Gastroenterol Date: 2017-08-15 Impact factor: 10.864
Authors: Marina Arvanitis; Darren A DeWalt; Christopher F Martin; Millie D Long; Wenli Chen; Beth Jaeger; Robert S Sandler; Michael D Kappelman Journal: J Pediatr Date: 2016-05-02 Impact factor: 4.406