Clinical Characteristics and Long-Term Outcomes of Paediatric Crohn's Disease: A Single-Centre Experience

Abstract

Background and aims: Although paediatric Crohn's disease [CD] has a different phenotype and clinical course to adult CD, its clinical features and surgical risks are poorly defined, especially in Asian countries. The aim of this study was to investigate the clinical features and long-term outcomes of paediatric CD in a Korean population.

Methods: We retrospectively analysed 594 patients who were younger than 18 years of age at CD diagnosis between 1987 and 2013. Patient characteristics at diagnosis according to the Paris classification and clinical courses were analysed.

Results: The male-to-female ratio was 2.4:1 and the median age at CD diagnosis was 15 years [range, 2-17 years]. A positive first-degree family history of inflammatory bowel disease was present in 30 patients [5.1%]. Sixty-seven patients [11.3%] showed growth impairment. The cumulative probabilities of perianal fistula at 1, 5 and 10 years after diagnosis were 50.3%, 54.9% and 57.6%, respectively. The cumulative probabilities of anti-tumour necrosis factor treatment at 1, 5, 10 and 20 years after diagnosis were 10.7%, 25.8%, 41.8% and 76.3%, respectively. The cumulative probabilities of intestinal resection at 1, 5, 10 and 20 years after diagnosis were 4.5%, 17.2%, 33.9% and 62.9 %, respectively. In multivariate analysis, complicated behaviour and isolated colonic location [L2] at diagnosis were associated with an increased and decreased risk of intestinal resection, respectively.

Conclusions: Our study is the largest Asian paediatric study which applied the Paris classification to patients. This study provides detailed information on disease phenotype and long-term clinical outcomes in a large cohort of Asian children with CD.

Keywords: Crohn’s disease; Korea; Pediatric.