Aims There has been at least a two-fold increase in the incidence of paediatric-onset CD 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 CD 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 106 children were included. Median age 13.80 (Range 4.40–17.32 years), 79 male. The most common presenting features are seen in Table 1. The majority of patients presented with ileocolonic disease (51%) or isolated colonic disease (32%). Twenty-eight patients (26.4%) had perianal signs (5.7% abscesses/fistulae).
Inflammatory markers were raised at diagnosis-median CRP 18.0 mg/L (8.9–27.1), ESR24.0 mm/hr (19.6–28.4); however normal inflammatory markers were frequently seen-normal CRP 26.4%, ESR 18.2%.
Weight SDS was –1.088 (–1.35 to –0.83), 52% patients were below –1 standard deviation (SD). Height SDS was –0.366 (–0.60 to –0.14). 26.5% of patients were between –1 and –2 SD from the median and 4.8% were below –2 SD.
Family history (3rd degree relative or closer) of IBD was seen in 27.6%.
Conclusion Despite an increase in incidence of CD there does not appear to be an accrual of milder cases of disease. A significant number of patients will present with both normal growth and normal inflammatory markers.
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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