Inflammatory bowel disease in children and adolescents in Italy: data from the pediatric national IBD register (1996-2003).

Ospedale Pediatrico Bambini Gesù, Roma, Italia.
Inflammatory Bowel Diseases (Impact Factor: 5.12). 09/2008; 14(9):1246-52. DOI: 10.1002/ibd.20470
Source: PubMed

ABSTRACT The purpose was to assess in Italy the clinical features at diagnosis of inflammatory bowel disease (IBD) in children.
In 1996 an IBD register of disease onset was established on a national scale.
Up to the end of 2003, 1576 cases of pediatric IBD were recorded: 810 (52%) ulcerative colitis (UC), 635 (40%) Crohn's disease (CD), and 131 (8%) indeterminate colitis (IC). In the period 1996-2003 an increase of IBD incidence from 0.89 to 1.39/10(5) inhabitants aged <18 years was observed. IBD was more frequent among children aged between 6 and 12 years (57%) but 20% of patients had onset of the disease under 6 years of age; 28 patients were <1 year of age. Overall, 11% had 1 or more family members with IBD. The mean interval between onset of symptoms and diagnosis was higher in CD (10.1 months) and IC (9 months) versus UC (5.8 months). Extended colitis was the most frequent form in UC and ileocolic involvement the most frequent in CD. Upper intestinal tract involvement was present in 11% of CD patients. IC locations were similar to those of UC. Bloody diarrhea and abdominal pain were the most frequent symptoms in UC and IC, and abdominal pain and diarrhea in CD. Extraintestinal symptoms were more frequent in CD than in UC.
The IBD incidence in children and adolescents in Italy shows an increasing trend for all 3 pathologies. UC diagnoses exceeded CD.

  • [Show abstract] [Hide abstract]
    ABSTRACT: BACKGROUND: It has been speculated that pediatric Crohn's disease (CD) is a distinct disease entity, with probably different disease subtypes. We therefore aimed to accurately phenotype newly diagnosed pediatric CD by using the pediatric modification of the Montreal classification, the Paris classification. METHODS: Information was collected from the EUROKIDS registry, a prospective, web-based registry of new-onset pediatric IBD patients in 17 European countries and Israel. When a complete diagnostic workup was performed (ileocolonoscopy, upper gastrointestinal [GI] endoscopy, small bowel imaging), CD patients were evaluated for ileocolonic disease extent, esophagogastroduodenal involvement, and jejunal/proximal ileal involvement. Disease behavior and the occurrence of granulomas were also analyzed. RESULTS: In all, 582 pediatric CD patients could be classified according to the Paris classification. Isolated terminal ileal disease (±limited cecal disease) was seen at presentation in 16%, isolated colonic disease in 27%, ileocolonic disease in 53%, and isolated upper GI disease in 4% of patients. In total, 30% had esophagogastroduodenal involvement and 24% jejunal/proximal ileal disease. Patients with L2 disease were less likely to have esophagogastroduodenal involvement or stricturing disease than patients with L1 or L3 disease. Terminal ileal disease and stricturing disease behavior were more common in children diagnosed after 10 years of age than in younger patients. Granulomas were identified in 43% of patients. CONCLUSIONS: Accurate phenotyping is essential in pediatric CD, as this affects the management of individual patients. Disease phenotypes differ according to age at disease onset. The Paris classification is a useful tool to capture the variety of phenotypic characteristics of pediatric CD. (Inflamm Bowel Dis 2012;).
    Inflammatory Bowel Diseases 05/2012; · 5.12 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: BACKGROUND There are great variations in the incidence and prevalence of inflammatory bowel diseases (IBD) among different populations. Epidemiologic studies mainly come from North America and Europe. Studies from Iran are mostly data on the adult population from the northern region of the country. METHODS Medical records of 37 pediatric patients (≤ 18 years of age) admitted in the Pediatric Gastroenterology Ward at Nemazee Hospital, from 2001 through 2007 with final diagnoses of IBD were reviewed regarding data such as clinical manifestations and colonoscopic findings. RESULTS There were 19 boys (52%) and 18 girls (48%) with a mean age of 10.3±4.9 years (range: 2-17 years). Of these, 26 (70%) had ulcerative colitis (UC), 9 (25%) were diagnosed with Crohn's disease (CD), and 2 (5%) were labeled as indeterminate colitis (IC). Bloody stools (84.6%) and pallor (80.8%) were the most common features in UC whereas growth failure (88.9%) followed by pallor (77.8%) were the most frequent symptoms in patients with CD. The most frequent colonoscopic findings in UC and CD were erythema (80%) and ulcer (71.4%) respectively. CONCLUSION This study provides available epidemiologic data on pediatric patients with IBD from Southern Iran.
    Middle East journal of digestive diseases. 04/2012; 4(2):102-6.
  • [Show abstract] [Hide abstract]
    ABSTRACT: OBJECTIVES:: Adolescence is a tough age for patients with inflammatory bowel disease (IBD), as they transition from child to adult medicine. Although a better understanding of the experience of illness and therefore a better response to the patient's needs have often been stressed, no studies have yet investigated the paediatricians' insight into their IBD adolescent patients. METHODS:: A group of adolescents (aged 12-19) diagnosed with IBD was administered a questionnaire listing 22 items of concern. They were asked to rank each item on a 5-point scale according to the degree of impact on the quality of their everyday life. The same questionnaire was administered to a group of paediatricians experienced in treating IBD and to a group of paediatric residents. Paediatricians and residents were asked to estimate how much each item would affect the quality of an average patient's life, according to the same scale. The questionnaire was also used in a face-to-face approach, asking a paediatrician to apply the estimation to an individual patient, instead of an average imaginary one. RESULTS:: Fifteen paediatric gastroenterologists, eleven paediatric residents and twenty-eight patients (female:male = 16:12; median age 16.3 years) took part in the study. The majority of patients suffered from Crohn Disease (17 vs. 11 with Ulcerative Colitis). We found only six items overlapping when comparing the top ten items ranked by patients and paediatricians. The patients' number one concern occupies the ninth position in the paediatricians' list. The number one item for paediatricians is not even mentioned in the patients' top ten list. Overall, both paediatricians' and residents' rankings were significantly higher than those given by patients. CONCLUSIONS:: We found a significant misalignment in the estimation of health concerns between IBD adolescent patients and their paediatricians. A better insight into IBD patients' worries and concerns is crucial for the improvement of the patient's quality of life and disease outcome.
    Journal of pediatric gastroenterology and nutrition 02/2013; · 2.18 Impact Factor


Available from
Jul 16, 2014