Infantile-onset inflammatory bowel disease has variable long-term outcomes

• Published in: Frontiers in pediatrics 2023-03, Vol.11, p.1097779-1097779
• Main Authors: Krauthammer, Alex, Weintraub, Ilana, Shaoul, Ron, Lev-Tzion, Raffi, Broide, Efrat, Wilschanski, Michael, Lerner, Aaron, Yerushalmi, Baruch, Shouval, Dror S, Shamaly, Hussein, Haberman-Ziv, Yael, Weiss, Batia
• Format: Article
• Language: English
• Subjects: infantile onset; inflammatory bowel disease; long-term outcome; Pediatrics; remission; surgery
• ISSN: 2296-2360; 2296-2360
• DOI: 10.3389/fped.2023.1097779

Infantile-onset inflammatory bowel disease (IO-IBD), defined as IBD diagnosed at age 2 years or younger, tends to be more severe and refractory to conventional treatment than IBD diagnosed at a later age. However, data about IO-IBD and its long-term follow up are limited. We thus aimed to evaluate the presentation and long-term outcomes of patients with IO-IBD in a retrospective multicenter study. Medical records of patients diagnosed with IO-IBD in eight medical centers during 2000-2017 with at least 1-year follow up were reviewed. Demographics and disease characteristics at diagnosis including age of onset, disease phenotype and location, surgeries, medical therapy, and comorbid conditions were recorded. Twenty-three patients with IO-IBD (16 males, 70%) were identified and followed for a median (range) of 51.2 (26.0-110.3) months. The mean ages at presentation and at the last follow up were 14 ± 9.8 and 101 ± 77 months, respectively. Six (26%) patients needed ileostomy already at the time of diagnosis and 20 (87%) were treated with corticosteroids. During long-term follow up, remission was achieved in 16 (73%) patients; of whom, 3 (14%) were without medications and 7 (32%) were in remission with the use of 5-aminosalicylic acid only. One patient needed hemicolectomy and one developed a severe EBV related infection. The majority of patients with IO-IBD achieved long-term remission, despite a severe disease presentation at diagnosis. Surgery rate however is high, mainly during the first months from diagnosis.