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Disease phenotype at diagnosis in pediatric Crohns disease: 5-year analyses of the EUROKIDS registry
Inflammatory Bowel Disease,  Clinical Article

de Bie CI et al. – Accurate phenotyping is essential in pediatric Crohn's disease (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.

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.

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