Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2009 Jan;15(1):63-8.
doi: 10.1002/ibd.20604.

Development of extraintestinal manifestations in pediatric patients with inflammatory bowel disease

Folashade Adebisi Jose  1 , Elizabeth A Garnett, Eric Vittinghoff, George D Ferry, Harland S Winter, Robert N Baldassano, Barbara S Kirschner, Stanley A Cohen, Benjamin D Gold, Oren Abramson, Melvin B Heyman
Affiliations

Development of extraintestinal manifestations in pediatric patients with inflammatory bowel disease

Folashade Adebisi Jose et al. Inflamm Bowel Dis. 2009 Jan.

Abstract

Background: Extraintestinal manifestations (EIMs) in pediatric patients with inflammatory bowel disease (IBD) are poorly characterized. We examined the prevalence of EIMs at diagnosis, subsequent incidence, and risk factors for EIMs.

Methods: Data for 1649 patients from the PediIBD Consortium Registry, diagnosed with IBD before 18 years of age (1007 [61%] with Crohn's disease, 471 [29%] with ulcerative colitis, and 171 [10%] with indeterminate colitis), were analyzed using logistic regression, Kaplan-Meier, log rank tests, and Cox models.

Results: EIMs were reported prior to IBD diagnosis in 97 of 1649 patients (6%). Older children at diagnosis had higher rates compared with younger children, and arthritis (26%) and aphthous stomatitis (21%) were most common. Among the 1552 patients without EIM at diagnosis, 290 developed at least 1 EIM. Kaplan-Meier estimates of cumulative incidence were 9% at 1 year, 19% at 5 years, and 29% at 15 years after diagnosis. Incidence did not differ by IBD type (P = 0.20), age at diagnosis (P = 0.22), or race/ethnicity (P = 0.24). Arthritis (17%) and osteopenia/osteoporosis (15%) were the most common EIMs after IBD diagnosis.

Conclusions: In our large cohort of pediatric IBD patients, 6% had at least 1 EIM before diagnosis of IBD. At least 1 EIM will develop in 29% within 15 years of diagnosis. The incidence of EIMs both before and after diagnosis of IBD differs by type of EIM and may be slightly higher in girls, but is independent of the type of IBD, age at diagnosis, and race/ethnicity.

PubMed Disclaimer

Figures

Figure1
Figure1
Kaplan Meier estimates of the cumulative incidence of EIM after diagnosis of IBD among patients with no history of EIM.
Figure 2
Figure 2
Kaplan Meier estimates of the cumulative incidence of EIM after diagnosis of IBD among patients with no history of EIM, stratified by age at IBD diagnosis.
Figure 3
Figure 3
Kaplan Meier estimates of the cumulative incidence of the most common EIMs after diagnosis of IBD.
See this image and copyright information in PMC

References

    1. Calkins BM, Mendeloff AI. Epidemiology of inflammatory bowel disease. Epidemiol Rev. 1986;8:60–91. - PubMed
    1. Bernstein CN. Extraintestinal manifestations of inflammatory bowel disease. Curr Gastroenterol Rep. 2001;3:477–83. - PubMed
    1. Lakatos L, Pandur T, David G, et al. Association of extraintestinal manifestations of inflammatory bowel disease in a province of western Hungary with disease phenotype: results of a 25-year follow-up study. World J Gastroenterol. 2003;9:2300–7. - PMC - PubMed
    1. Mendoza JL, Lana R, Taxonera C, Alba C, Izquierdo S, Diaz-Rubio M. [Extraintestinal manifestations in inflammatory bowel disease: differences between Crohn’s disease and ulcerative colitis] Med Clin (Barc) 2005;125:297–300. - PubMed
    1. Repiso A, Alcantara M, Munoz-Rosas C, et al. Extraintestinal manifestations of Crohn’s disease: prevalence and related factors. Rev Esp Enferm Dig. 2006;98:510–7. - PubMed

Publication types

MeSH terms