Aims There has been a two-fold increase in the incidence of paediatric-onset UC over the last 20 years; there are few recent reports of the presenting phenotype – symptoms, inflammatory markers and disease extent. We report the presenting features of a defined cohort and compare to previous data.
Methods Patients diagnosed with UC at University Hospitals Southampton from 2010–2013 were identified from an in-house database. Data were obtained from note review using a standardised proforma and compared to previous UK data.1 Weight and height at diagnosis are presented as median SDS (95% CI).
Results 49 children were included. Median age 13.18 (Range 1.59–16.24 years), 27 male. The most common presenting features are seen in Table 1. Weight loss (36.7%) and lethargy (36.7%) were less common. The majority of patients presented with pancolitis (68.1%).
A significant number of patients present with normal inflammatory markers (percentage with normal CRP 69.4%, normal ESR 34.9%). Median CRP 3.0 mg/L (0.0–12–9), ESR21.5 mm/hr (15.2–26.8)).
Weight SDS was 0.14 (–0.20 to 0.48). Seventeen patients (39.5%) were greater than 1 SD above the median. Seven patients (15.9%) were between –1 and –2 SD. Height SDS at diagnosis was 0.5315 (0.19 to 0.87). Thirty percent were overweight (BMI >1 SD above the median) at diagnosis.
Positive family history (3rd degree relative or closer) of IBD was seen in 26.5%.
Conclusion Growth delay and raised inflammatory markers are seen in a minority of cases of UC at presentation. The majority of patients present with the classical triad of blood in stools, diarrhoea and abdominal pain however this is not invariable and absence does not preclude a diagnosis of UC.
Sawczenko A. Presenting features of inflammatory bowel disease in Great Britain and Ireland. Arch Dis Child. 2003;88(11):995–1000
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