scholarly journals Phenotypic characteristics of pediatric inflammatory bowel disease in Japan: results from a multicenter registry

2020 ◽  
Vol 18 (4) ◽  
pp. 412-420
Author(s):  
Katsuhiro Arai ◽  
Reiko Kunisaki ◽  
Fumihiko Kakuta ◽  
Shin-ichiro Hagiwara ◽  
Takatsugu Murakoshi ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Demographic Data ◽  
Japanese Children ◽  
Cross Sectional ◽  
Pediatric Inflammatory Bowel Disease ◽  
Inflammatory Bowel ◽  
Paris Classification ◽  
Multicenter Registry ◽  
Pediatric Ibd

Background/Aims: There are few published registry studies from Asia on pediatric inflammatory bowel disease (IBD). Registry network data enable comparisons among ethnic groups. This study examined the characteristics of IBD in Japanese children and compared them with those in European children.Methods: This was a cross-sectional multicenter registry study of newly diagnosed Japanese pediatric IBD patients. The Paris classification was used to categorize IBD features, and results were compared with published EUROKIDS data.Results: A total of 265 pediatric IBD patients were initially registered, with 22 later excluded for having incomplete demographic data. For the analysis, 91 Crohn’s disease (CD), 146 ulcerative colitis (UC), and 6 IBD-unclassified cases were eligible. For age at diagnosis, 20.9% of CD, 21.9% of UC, and 83.3% of IBD-unclassified cases were diagnosed before age 10 years. For CD location, 18.7%, 13.2%, 64.8%, 47.3%, and 20.9% were classified as involving L1 (ileocecum), L2 (colon), L3 (ileocolon), L4a (esophagus/stomach/duodenum), and L4b (jejunum/proximal ileum), respectively. For UC extent, 76% were classified as E4 (pancolitis). For CD behavior, B1 (non-stricturing/non-penetrating), B2 (stricturing), B3 (penetrating), and B2B3 were seen in 83.5%, 11.0%, 3.3%, and 2.2%, respectively. A comparison between Japanese and European children showed less L2 involvement (13.2% vs. 27.3%, <i>P</i>< 0.01) but more L4a (47.3% vs. 29.6%, <i>P</i>< 0.01) and L3 (64.8% vs. 52.7%, <i>P</i>< 0.05) involvement in Japanese CD children. Pediatric perianal CD was more prevalent in Japanese children (34.1% vs. 9.7%, <i>P</i>< 0.01).Conclusions: Upper gastrointestinal and perianal CD lesions are more common in Japanese children than in European children.

Phenotypic Features and Longterm Outcomes of Pediatric Inflammatory Bowel Disease Patients with Arthritis and Arthralgia

2017 ◽  
Vol 44 (11) ◽  
pp. 1636-1643 ◽  
Author(s):  
Osnat Nir ◽  
Firas Rinawi ◽  
Gil Amarilyo ◽  
Liora Harel ◽  
Raanan Shamir ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Medical Records ◽  
Biologic Therapy ◽  
Joint Involvement ◽  
Pediatric Inflammatory Bowel Disease ◽  
History Of ◽  
Inflammatory Bowel ◽  
Phenotypic Features ◽  
Pediatric Ibd

Objective.The natural history of pediatric inflammatory bowel disease (IBD) patients with joint involvement has not been clearly described. Thus, we aimed to investigate phenotypic features and clinical outcomes of this distinct association.Methods.The medical records of patients with pediatric IBD diagnosed from 2000 to 2016 were reviewed retrospectively. Main outcome measures included time to first flare, hospitalization, surgery, and biologic therapy.Results.Of 301 patients with Crohn disease (median age 14.2 yrs), 37 (12.3%) had arthritis while 44 (14.6%) had arthralgia at diagnosis. Arthritis and arthralgia were more common in women (p = 0.028). Patients with arthritis and arthralgia demonstrated lower rates of perianal disease (2.7% and 4.5% vs 16.9%, p = 0.013), whereas patients with arthritis were more likely to be treated with biologic therapy (HR 2.05, 95% CI 1.27–3.33, p = 0.009). Of 129 patients with ulcerative colitis (UC; median age 13.7 yrs), 3 (2.3%) had arthritis and 16 (12.4%) had arthralgia at diagnosis. Patients with arthralgia were treated more often with corticosteroids (p = 0.03) or immunomodulator therapies (p = 0.003) compared with those without joint involvement. The likelihood to undergo colectomy was significantly higher in patients with arthralgia (HR 2.9, 95% CI 1.1–7.4, p = 0.04). During followup (median 9.0 yrs), 13 patients developed arthritis (3.3%). Arthralgia at diagnosis was a significant predictor for the development of arthritis during followup (HR 9.0, 95% CI 2.86–28.5, p < 0.001).Conclusion.Pediatric IBD patients with arthritis have distinct phenotypic features. Arthralgia at diagnosis is a predictor for colectomy in UC and a risk factor for the development of arthritis during followup.

scholarly journals Trends in Early Outpatient Drug Therapy in Pediatric Inflammatory Bowel Disease in Finland: A Nationwide Register-Based Study in 1999–2009

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Lauri J. Virta ◽  
Kaija-Leena Kolho
Keyword(s):  
Inflammatory Bowel Disease ◽  
Crohn’S Disease ◽  
Drug Therapy ◽  
Crohn's Disease ◽  
Bowel Disease ◽  
Early Years ◽  
Aminosalicylic Acid ◽  
Pediatric Inflammatory Bowel Disease ◽  
Inflammatory Bowel ◽  
Pediatric Ibd

Objective. There are limited data on the changes of treatment strategies of disease-modifying drugs used to treat pediatric inflammatory bowel disease (IBD). Methods. We utilized data from two national registers: the Drug Reimbursement Register for drug costs (for identifying children with IBD) and the Drug Purchase Register (for exposure to drugs), both of which are maintained by the Social Insurance Institution of Finland. The frequencies and trends of drug therapy strategies during the first year of pediatric IBD were evaluated between 1999 and 2009. Results. A total of 481 children diagnosed with IBD were identified. During the first six months, 68% of the patients purchased systemic corticosteroids; these combined with 5-aminosalicylic acid in almost all cases. The use of corticosteroids was stable from the early years compared with the end of the study period. In Crohn's disease, there was a trend towards more active use of azathioprine: the therapy was introduced earlier and proportion of pediatric patients purchasing azathioprine increased by up to 51% (P<0.05). Conclusions. In pediatric IBD, the majority of patients purchased corticosteroid within the first six months, reflecting moderate-to-severe disease. During recent years in pediatric Crohn's disease, the therapeutic strategies of oral medication have changed towards more active immunosuppression with azathioprine.

scholarly journals Incidence and Prevalence Trends of Pediatric Inflammatory Bowel Disease in the Daegu-Kyungpook Province From 2017 to 2020

2022 ◽  
Vol 9 ◽  
Author(s):  
Jae Young Choe ◽  
Sujin Choi ◽  
Ki Hwan Song ◽  
Hyo-Jeong Jang ◽  
Kwang-Hae Choi ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Children And Adolescents ◽  
Bowel Disease ◽  
Population Based ◽  
Annual Number ◽  
Number Of Children ◽  
Pediatric Inflammatory Bowel Disease ◽  
Prevalence Trends ◽  
Inflammatory Bowel ◽  
Pediatric Ibd

Background and Aim: There is paucity of data regarding the epidemiology of pediatric IBD in Asia compared to that of Western countries. We aimed to investigate the incidence and prevalence trends of pediatric inflammatory bowel disease (IBD) in the Daegu-Kyungpook province of South Korea from 2017 to 2020.Methods: This study was a multicenter, retrospective study conducted in eight IBD referral centers located in the Daegu-Kyungpook province. Children and adolescents of ≤18 years who were initially diagnosed with IBD between 2017 and 2020 were included. The annual number of children and adolescents newly diagnosed with IBD and the annual resident population of children and adolescents ≤18 years of age in the Daegu-Kyungpook province were investigated to calculate the annual incidence and prevalence in the region.Results: A total 304 children and adolescents that had been diagnosed with IBD were included in this study. Among these patients, 71.4% had been diagnosed with Crohn's disease (CD), and 28.6% with ulcerative colitis (UC). The population based annual incidences of IBD from 2017 to 2020 were each 7.24, 6.82, 10.27, and 13.33 per 100,000, respectively (P for trend &lt;0.001), 4.48, 5.26, 7.39, and 9.8 per 100,000, respectively, for CD (P for trend &lt;0.001), and 2.76, 1.56, 2.88, and 3.53 per 100,000, respectively, for UC (P for trend = 0.174).Conclusion: Pediatric IBD, especially CD has significantly increased recently in the Daegu-Kyungpook province. Epidemiology studies from other regions of Asia are required to better elucidate this trend of increase in Asia.

scholarly journals Incidence and Paris Classification of Pediatric Inflammatory Bowel Disease

2014 ◽  
Vol 2014 ◽  
pp. 1-10 ◽  
Author(s):  
Katalin Eszter Müller ◽  
Peter Laszlo Lakatos ◽  
Maria Papp ◽  
Gabor Veres
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Western Europe ◽  
Epidemiological Data ◽  
Epidemiological Studies ◽  
Incidence Trends ◽  
Colonic Involvement ◽  
Inflammatory Bowel ◽  
Paris Classification ◽  
Pediatric Ibd

New epidemiological data suggest that the incidence of inflammatory bowel disease (IBD) is increasing. As a result the burden of disease accounts for more strains to the health care system. The clinical variability queries whether disease characteristics are related to clinical outcome. Our aim was to delineate the latest results of incidence trends in pediatric IBD and to compare the first experiences with Paris Classification. Incidence of pediatric IBD has been increasing in Western Europe and in Eastern Europe. To better characterize IBD, Paris Classification was introduced and validated recently. Ileocolonic involvement is the most characteristic disease location in Crohn’s disease (CD) based on applying Paris Classification. The rate of perianal disease and complicated behaviour in CD was similar. It is of interest that CD patients with colonic involvement were less likely to have stricturing disease compared with patients with ileal involvement. In addition, pancolitis dominated in ulcerative colitis (UC). However, most countries lack prospective, nationwide epidemiological studies to estimate incidence trends. This review emphasizes the importance of nationwide registries that enroll all pediatric IBD cases serving reliable data for “everyday practice.” These first reports have shown that Paris Classification is a useful tool to determine the pediatric IBD phenotype.

Pediatric hospitalizations for inflammatory bowel disease based on annual case volume: results from the Kids’ Inpatient Database 2012

2016 ◽  
Vol 65 (1) ◽  
pp. 94-96 ◽  
Author(s):  
Chaitanya Pant ◽  
Abhishek Deshpande ◽  
Thomas J Sferra ◽  
Osama Almadhoun ◽  
Daisy Batista ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Surgical Procedures ◽  
Bowel Disease ◽  
High Volume ◽  
The United States ◽  
Case Volume ◽  
Cross Sectional ◽  
Inflammatory Bowel ◽  
Inpatient Database ◽  
Pediatric Ibd

To study differences related to pediatric inflammatory bowel disease (IBD) care among hospitals that were stratified based on annual case volume. This is a cross-sectional study using data from the United States Healthcare Cost and Utilization Project Kids’ Inpatient Database (KID). IBD-related hospitalizations were identified using International Classification of Diseases-9-Clinical Modification codes. Hospital volume was divided into low or high by assigning cut-off values of 1–20 and >20 annual IBD hospitalizations. We assessed a total of 8647 pediatric IBD discharges during 2012 from 660 hospitals in the USA. 107 of these hospitals were classified as high-volume centers (HVCs) for pediatric IBD care and 553 low-volume centers (LVCs). HVCs were more likely to be associated with an academic teaching status compared to LVCs (97.1% vs 67.6%, p<0.001). The incidence of transfer of medical care from LVCs to other hospitals was 5.5% but only 0.7% for HVCs (p<0.001). The median number of procedures (medical and surgical) performed on children admitted with IBD was higher at HVCs (2 vs 1, p<0.001). IBD admissions at HVCs were more likely to undergo surgical procedures compared to LVCs (17% vs 10%, p<0.001). The incidence of postoperative complications was not significantly different. There were significantly greater hospital costs (median US$11,000 vs US$6,000, p<0.001) and lengths of stay (median 5 days vs 4 days, p<0.001) associated with HVCs compared to LVCs. Pediatric admissions to HVCs for IBD undergo a greater number of medical and surgical procedures and are associated with higher costs and lengthier hospital stays.

scholarly journals Comparison of Fecal Calprotectin Methods for Predicting Relapse of Pediatric Inflammatory Bowel Disease

2017 ◽  
Vol 2017 ◽  
pp. 1-10 ◽  
Author(s):  
Saranya Kittanakom ◽  
Md. Sharif Shajib ◽  
Kristine Garvie ◽  
Joceline Turner ◽  
Dan Brooks ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Clinical Performance ◽  
Fecal Calprotectin ◽  
Analytical Performance ◽  
Medical Decision ◽  
Specific Marker ◽  
Pediatric Inflammatory Bowel Disease ◽  
Inflammatory Bowel ◽  
Pediatric Ibd

Background.Pediatric inflammatory bowel disease (IBD) is on the rise worldwide. Endoscopies are necessary for IBD assessment but are invasive, expensive, and inconvenient. Recently, fecal calprotectin (FCal) was proposed as a noninvasive and specific marker of gut inflammation. We evaluated the analytical performance of three FCal assays and their clinical performance in predicting relapse in pediatric IBD.Methods.This study used 40 pediatric IBD and 40 random non-IBD patients’ fecal samples. Two automated ELISAs (Bühlmann and PhiCal® Calprotectin-EIA) and an EliA (Phadia 250 EliA-Calprotectin) were used to evaluate the analytical performance. The clinical performance was assessed by PhiCal Calprotectin-EIA, EliA-Calprotectin, and Bühlmann immunochromatographic point-of-care test (POCT).Results.All assays displayed acceptable analytical performance below and above the medical decision cut-off [imprecision (CV < 10% intra-assay; <15% interassay); linearity (overall mean % deviation < 16.5%)]. The agreement with PhiCal Calprotectin-EIA was 100% and 78.6% for Bühlmann (95% CI, 87.5–100; Kappa: 1) and EliA-Calprotectin (95% CI, 60.5–89.8; Kappa: 0.32), respectively, and 63.6% between Bühlmann and EliA-Calprotectin (95% CI, 46.6–77.8; Kappa: 0.16). All assays evaluated had similar clinical performance [AUC: 0.84 (EliA-Calprotectin); 0.83 (POCT and PhiCal Calprotectin-EIA)].Conclusion.FCal levels determined using the same method and assay together with clinical history would be a noninvasive and useful tool in monitoring pediatric IBD.

Role of Cross-Sectional Imaging in Pediatric Inflammatory Bowel Disease

2021 ◽  
Author(s):  
Aurélie Grandmougin ◽  
Ferdinando D’Amico ◽  
Thomas Remen ◽  
Silvio Danese ◽  
Marjorie Bonneton ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Cross Sectional ◽  
Pediatric Inflammatory Bowel Disease ◽  
Cross Sectional Imaging ◽  
Inflammatory Bowel ◽  
Sectional Imaging

scholarly journals IMMUNIZATION STATUS OF PATIENTS WITH INFLAMMATORY BOWEL DISEASE

2019 ◽  
Vol 56 (2) ◽  
pp. 124-130 ◽  
Author(s):  
Karin Lye auf der STRASSE ◽  
Carmen Mayanna JAMUR ◽  
Janaina MARQUES ◽  
Mirian Su Mi KIM ◽  
Ricardo Rasmussen PETTERLE ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Hepatitis B ◽  
Influenza Vaccine ◽  
Bowel Disease ◽  
Demographic Data ◽  
Biological Agents ◽  
University Hospital ◽  
Cross Sectional ◽  
Immunization Status ◽  
Inflammatory Bowel

ABSTRACT BACKGROUND: Treatment for inflammatory bowel disease (IBD) includes a variety of immunosuppressants and biological agents, which increase the risk of infections due to altered cellular and humoral immunity. Prevention of these infections can be done through vaccination, however, patients with IBD are usually under-immunized. OBJECTIVE: Analyze the immunization status of patients with IBD and confront it with the current recommendations to verify if the immunization guidelines are being followed correctly. METHODS: Analytical cross-sectional study including 239 IBD patients being regularly followed in the Gastroenterology Service from Hospital de Clínicas da Universidade Federal do Paraná, which were subjected to a survey about their relevant demographic data and immunization status. RESULTS: The amount of patients that declared being unaware of their immunization status is high - between 34.3% (Tdap) and 52% (meningococcal) - excepting IIV, hepatitis B and HPV. The vaccines with the largest rates of patients declaring to have taken it are inactivated influenza vaccine (72.4%), BCG (55.3%), hepatitis B (48.3%), measles, mumps and rubella vaccine (43.8%) and DTaP (43%). The vaccines with the lowest rates of patients declaring to have taken it are Haemophilus influenza type b (0.8%), herpes zoster (2.1%) and HPV (3.4%). Patients that are being treated or have been treated with biological therapy have the largest immunization coverage for inactivated influenza vaccine (81%) and PPSV23 (25.9%), also they have the largest awareness rates for those vaccines. CONCLUSION: Although being a specialized service linked to a university hospital, vaccination coverage and patients’ awareness rates proved to be below the desirable level. Vaccination and recovery of the immunization history is recommended immediately after the diagnosis of IBD, regardless of the use of biological agents. Those findings support the need of implementing hospital guidelines and constantly verifying its application by the multidisciplinary team in specialized services in IBD.

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