Clinical and paraclinical characteristics of inflammatory bowel diseases with very early onset in children
DOI:
https://doi.org/10.15574/PP.2024.3(99).8795Keywords:
young children, inflammatory bowel disease, Crohn's disease, ulcerative colitis, diagnosisAbstract
Over recent decades, there has been a notable increase in the incidence of inflammatory bowel disease (IBD) among children under the age of six. The management of such patients is challenging due to the severe and treatment-resistant course of the disease, alongside atypical presentations.
Aim - examine the clinical and paraclinical features of IBD with an onset at a very young age.
Materials and methods. The study involved 10 young children diagnosed with IBD including 3 with Crohn's Disease (CD), 2 with Ulcerative Colitis (UC), and 5 with an unclassified form of IBD. Clinical, anamnestic, laboratory, endoscopic, and histopathological methods was employed to gather comprehensive data on each case.
Results. Six children experienced a severe course, while four had a moderate disease course. Identified triggers included COVID-19 or rotavirus infections, food allergies, and early artificial feeding. Three children had a family history of IBD. For 80% of children, IBD onset occurred within the first year of life following the escalation of war in Ukraine, with a severe, treatment-resistant progression. Symptoms and laboratory findings were similar in children with CD and UC. Endoscopic and histopathological findings revealed the chronic inflammation in the colon of 80% patients, with two CD patients showing terminal ileitis. In 50% of cases, endoscopic and histological features were ambiguous, presenting characteristics of both CD and UC (IBD- unclassified).
Conclusion. IBD in early childhood is marked by high inflammatory activity involving the entire colon, with overlapping clinical, endoscopic, and histopathological characteristics between CD and UC, complicating accurate diagnosis and expanding the group classified as IBD- unclassified.
The study adhered to the Helsinki Declaration principles, received ethical approval from local ethical committee, and obtained parental consent for child participation.
Authors report no conflicts of interest.
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