Extraintestinal Manifestations of Pediatric Inflammatory Bowel Disease: Prevalence, Presentation and anti-TNF Treatment.

Greuter, Thomas; Bertoldo, Fabio; Rechner, Roman; Straumann, Alex; Biedermann, Luc; Zeitz, Jonas; Misselwitz, Benjamin; Scharl, Michael; Rogler, Gerhard; Safroneeva, Ekaterina; Ali, Raja A; Braegger, Christian; Heyland, Klaas; Mueller, Pascal; Nydegger, Andreas; Petit, Laetitia-Marie; Schibli, Susanne; Furlano, Raoul I; Spalinger, Johannes; Schäppi, Michela; ... (2017). Extraintestinal Manifestations of Pediatric Inflammatory Bowel Disease: Prevalence, Presentation and anti-TNF Treatment. Journal of pediatric gastroenterology and nutrition, 65(2), pp. 200-206. Lippincott Williams & Wilkins 10.1097/MPG.0000000000001455

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BACKGROUND There is a paucity of data on extraintestinal manifestations (EIM) and their treatment in pediatric patients with inflammatory bowel disease (IBD). METHODS Since 2008, the Pediatric Swiss IBD Cohort Study has collected data on the pediatric IBD population in Switzerland. Data on 329 patients were analyzed retrospectively. RESULTS 55 patients (16.7%) suffered from 1-4 EIM (39 Crohn's disease, 12 ulcerative colitis and 4 IBD-Unclassified (IBD-U) patients). At IBD onset, presence of EIM was more frequent than in the adult population (8.5% vs. 5.0%, p = 0.014). EIM were more frequent in CD when compared to UC/IBD-U (22.5 vs. 10.3%, p = 0.003). The most prevalent EIM were peripheral arthritis (26/329, 7.9%) and aphthous stomatitis (24/329, 7.3%). 27.6% of all EIM appeared before IBD diagnosis. Median time between IBD diagnosis and occurrence of first EIM was 1 month (-37.5-149.0). 31 of the 55 patients (56.4%) were treated with one or more anti-TNF agents. IBD patients with EIM were more likely to be treated with anti-TNF compared to those without (56.4% vs. 35.0%, p = 0.003). Response rates to anti-TNF depended on underlying EIM and were best for peripheral arthritis (61.5%) and uveitis (66.7%). CONCLUSIONS In a cohort of pediatric IBD patients, EIM were frequently encountered. In up to 30%, EIM appeared before IBD diagnosis. Knowledge of these findings might translate into an increased awareness of underlying IBD, thereby decreasing diagnostic delay. Anti- TNF for the treatment of certain EIM is effective although a substantial proportion of new EIM might present despite ongoing anti-TNF therapy.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Paediatric Medicine
04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine (ISPM)

UniBE Contributor:

Safroneeva, Ekaterina and Schibli, Susanne

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

0277-2116

Publisher:

Lippincott Williams & Wilkins

Language:

English

Submitter:

Doris Kopp Heim

Date Deposited:

16 Feb 2017 13:02

Last Modified:

05 Nov 2019 19:15

Publisher DOI:

10.1097/MPG.0000000000001455

PubMed ID:

27801751

BORIS DOI:

10.7892/boris.95972

URI:

https://boris.unibe.ch/id/eprint/95972

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