Early onset inflammatory bowel disease – What the radiologist needs to know

•Early-onset IBD presents before the age of 10 years; very early onset disease presents before the age of 6 years.•Inflammation limited to the colon is frequently seen in early onset disease.•Several monogenetic mutations are specific for early onset IBD.•Imaging these patients is complex are requir...

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Bibliographic Details
Published in:European journal of radiology 2018-09, Vol.106, p.173-182
Main Authors: Barber, J.L., Shah, N., Watson, T.A.
Format: Article
Language:English
Subjects:
Adolescent
Age of Onset
Child
Child, Preschool
Diagnostic Imaging - methods
Female
Gastrointestinal Tract - diagnostic imaging
Gastrointestinal Tract - physiopathology
Humans
Infant
Infant, Newborn
Inflammatory Bowel Diseases - diagnostic imaging
Inflammatory Bowel Diseases - physiopathology
Male
Monogenic
MR enterography
Paediatric
VEO-IBD
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Summary:•Early-onset IBD presents before the age of 10 years; very early onset disease presents before the age of 6 years.•Inflammation limited to the colon is frequently seen in early onset disease.•Several monogenetic mutations are specific for early onset IBD.•Imaging these patients is complex are requires a multi-modality approach. Approximately 25% of Inflammatory Bowel Disease (IBD) patients present before the age of 18 years; early-onset IBD is defined as disease presenting before 10 years of age. Although early-onset disease is rare, it presents a particular challenge both in terms of treatment and diagnosis. There is a strong genetic component to these diseases and it is now possible to identify specific genetic mutations associated with certain patterns of early-onset IBD. All of these children require specific clinical work-up that is often performed at specialist centres. Young children with IBD, present a particular challenge to the radiologist because conventional bowel imaging techniques such as MR Enterography require general anaesthetic and other techniques such as CT or fluoroscopy must be carefully considered given the increased susceptibility to radiation in this young patient population. In this paper, we present a review of the aetiology, clinical work-up, differential diagnosis, and latest theories on the genetics of early-onset and very-early onset (
ISSN:0720-048X
1872-7727
DOI:10.1016/j.ejrad.2018.07.001