RT Journal Article
T1 Perianal Pediatric Crohn Disease Is Associated With a Distinct Phenotype and Greater Inflammatory Burden.
A1 Assa, Amit
A1 Amitai, Michal
A1 Greer, Mary-Louise
A1 Castro, Denise A
A1 Kuint, Ruth C
A1 Martínez-León, Maria
A1 Herman-Sucharska, Izabela
A1 Coppenrath, Eva
A1 Anupindi, Sudha
A1 Towbin, Alexander
A1 Moote, Douglas
A1 Konen, Osnat
A1 Pratt, Li-Tal
A1 Griffiths, Anne
A1 Turner, Dan
A1 ImageKids Study Group, 
AB Data on the outcomes of children with perianal Crohn disease (pCD) are limited, although its presence is often used for justifying early use of biologics. We aimed to assess whether pCD in children is associated with more severe outcomes as found in adults. Data were extracted from the ImageKids database, a prospective, multicenter, longitudinal cohort study. The study enrolled 246 children at disease onset or thereafter. All patients underwent comprehensive clinical, endoscopic, and radiologic evaluation at enrollment; 98 children had repeat evaluation at 18 months. Of the 234 included patients (mean age 14.2 ± 2.4 years; 131 [56%] boys), 57 (24%) had perianal findings, whereas only 21 (9%) had fistulizing perianal disease. Children with pCD had reduced weight and height z scores compared with non-pCD patients (-0.9 vs -0.35, P = 0.03 and -0.68 vs -0.23, respectively; P = 0.04), higher weighted pediatric CD activity index (32 [interquartile range 16-50] vs 20 [8-37]; P = 0.004), lower serum albumin (3.6 ± 0.7 vs 4.5 ± 0.8, P = 0.016), and higher magnetic resonance enterography global inflammatory score (P = 0.04). Children with pCD had more rectal (57% vs 38%, P = 0.04), and jejunal involvement (31% vs 11% P = 0.003) and a higher prevalence of granulomas (64% vs 23%, P = 0.0001). Magnetic resonance enterography-based damage scores did not differ between groups. Patients with skin tags/fissures only, had similar clinical, endoscopic, and radiologic characteristics as patients with no perianal findings. Pediatric patients with pCD with fistulizing disease have distinct phenotypic features and a predisposition to a greater inflammatory burden.
YR 2017
FD 2017
LK http://hdl.handle.net/10668/11030
UL http://hdl.handle.net/10668/11030
LA en
DS RISalud
RD Apr 10, 2025