Pediatric Crohn's Disease

Abstract

The incidence of Crohn's disease in the pediatric population is increasing. While pediatric patients with Crohn's disease exhibit many of the characteristics of older patients, there are important differences in the clinical presentation and course of disease that can impact the clinical decisions made during treatment. The majority of children are diagnosed in the early teen years, but subgroups of very early onset and infantile Crohn's present much earlier and have a unique clinical course. Treatment paradigms follow the traditional laddered approach, but growth and development represent special considerations that must be given to pediatric-specific complications of the treatment and disease. Surgical intervention is an important component of Crohn's management and is often employed to allow improved nutritional intake or decrease reliance on medical treatments that compromise growth.

Current global trends in the incidence of pediatric-onset inflammatory bowel disease

“…Many explanations have been proposed, but the hypothesis that exposure to environmental and genetic factors is a fundamental contributor to the development of IBD has been challenged by several new observations[ 6 - 10 ]. Whether the etiology of pediatric-onset IBD differs from that of adult-onset IBD remains unknown[ 11 ]. Thus, there is a great need to summarize global information regarding the pediatric IBD incidence and disease burden in different settings and perform subsequent analyses of the underlying factors.…”

Biomarkers for Optimization and Personalization of Anti-TNFs in Pediatric Inflammatory Bowel Disease

“…In pCD, the median time to first surgery is longer than in patients who debut in adulthood, although the need for surgery in pUC is earlier than in adults. Consequently, the risk of surgical resection before the age of 30 years is higher in children than in adults [39].…”

Gingival manifestation of Crohn’s disease in a paediatric patient: A case report

“…Children and adolescents also suffer from IBDs: indeed, around 20–25% of the people affected by IBDs are younger than 18 years old. In particular, the incidence of CD in the paediatric population is increasing from 2.5 to 11.4 per 100.000, with a prevalence of 58 per 100.000 4 …”

“…Clinical symptoms include abdominal pain, diarrhoea, weight loss and extra‐intestinal manifestations, such as primarily peripheral arthritis, ankylosing spondylitis, uveitis and erythema nodosum 3 . The location of the intestinal lesions in paediatric patients is combined ileo‐colonic disease in 53%, isolated colonic in 27% and limited cecal in 16% 4 . According to Paris classification, there are four main features to be considered when evaluating CD in a paediatric patient: age of onset, disease location, disease behaviour and effects on the patient's growth 5 .…”