Front Pediatr. 2023 Mar 1;11:1097779. doi: 10.3389/fped.2023.1097779. eCollection 2023.

Alex Krauthammer ^1 2, Ilana Weintraub ¹, Ron Shaoul ³, Raffi Lev-Tzion ⁴, Efrat Broide ⁵, Michael Wilschanski ⁶, Aaron Lerner ⁷, Baruch Yerushalmi ⁸, Dror S Shouval ⁹, Hussein Shamaly ¹⁰, Yael Haberman-Ziv ^1 2, Batia Weiss ^1 2

Author information

¹Pediatric Gastroenterology Unit, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel hashomer, Israel.

²Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel.

³Pediatric Gastroenterology Unit, Faculty of Medicine, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, Haifa, Israel.

⁴Paediatric Gastroenterology, Shaare Zedek Medical Centre, Jerusalem, Israel.

⁵Pediatric Gastroenterology Unit, Shamir Medical Center, Sackler Faculty of Medicine Tel Aviv University, Tel Aviv, Israel.

⁶Pediatric Gastroenterology Unit, Hadassah Hebrew University Hospital, Jerusalem, Israel.

⁷Pediatric Gastroenterology and Nutrition Unit, Carmel Medical Center, B, Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.

⁸Pediatric Gastroenterology Unit, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.

⁹Institute of Gastroenterology, Nutrition and Liver Diseases, Schneider Children's Medical Center, Sackler Faculty of Medicine Tel-Aviv University, Tel Aviv, Israel.

¹⁰Department of Pediatrics, Saint Vincent de Paul-French Hospital, Nazareth, Israel.

Abstract

Objective and aim: Infantile-onset inflammatory bowel disease (IO-IBD), defined as IBD diagnosed at age 2 years or younger, tends to be more severe and refractory to conventional treatment than IBD diagnosed at a later age. However, data about IO-IBD and its long-term follow up are limited. We thus aimed to evaluate the presentation and long-term outcomes of patients with IO-IBD in a retrospective multicenter study.

Methods: Medical records of patients diagnosed with IO-IBD in eight medical centers during 2000-2017 with at least 1-year follow up were reviewed. Demographics and disease characteristics at diagnosis including age of onset, disease phenotype and location, surgeries, medical therapy, and comorbid conditions were recorded.

Results: Twenty-three patients with IO-IBD (16 males, 70%) were identified and followed for a median (range) of 51.2 (26.0-110.3) months. The mean ages at presentation and at the last follow up were 14 ± 9.8 and 101 ± 77 months, respectively. Six (26%) patients needed ileostomy already at the time of diagnosis and 20 (87%) were treated with corticosteroids. During long-term follow up, remission was achieved in 16 (73%) patients; of whom, 3 (14%) were without medications and 7 (32%) were in remission with the use of 5-aminosalicylic acid only. One patient needed hemicolectomy and one developed a severe EBV related infection.

Conclusion: The majority of patients with IO-IBD achieved long-term remission, despite a severe disease presentation at diagnosis. Surgery rate however is high, mainly during the first months from diagnosis.