Incidence and risk factors of extraintestinal manifestations in children with inflammatory bowel disease
10.3760/cma.j.issn.0578-1310.2019.09.009
- VernacularTitle: 儿童炎症性肠病肠外表现发生率及危险因素
- Author:
Chengyan SHAN
1
;
Qingqing ZHANG
2
;
Yuan XIAO
3
;
Xinqiong WANG
3
;
Yi YU
3
;
Xu XU
3
;
Chundi XU
2
Author Information
1. Department of Pediatrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China (Shan Chengyan is working on the Department of pediatrics, Yantai Yuhuangding Hospital, Yan tai 264000, China)
2. Department of Pediatrics, Ruijin Hospital North, Shanghai Jiao Tong University School of Medicine, Shanghai 201800, China
3. Department of Pediatrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
- Publication Type:Clinical Trail
- Keywords:
Child;
Risk factors;
Retrospective studies
- From:
Chinese Journal of Pediatrics
2019;57(9):694-699
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the incidence and risk factors of extraintestinal manifestations (EIMs) in children with inflammatory bowel disease (IBD).
Methods:The clinical data of 161 children with IBD was collected from the electronic medical records in the Department of Pediatrics, Ruijin Hospital, Shanghai Jiao Tong University, School of Medicine from January 2012 to December 2017. These patients were divided into Crohn′s disease (CD) group and ulcerative colitis (UC) group, accounting for 82.0% (132 cases) and 18.0%(29 cases), respectively. The incidence of EIMs in each group was analyzed. The potential risk factors of EIMs including the IBD phenotype, gender, age, location of the CD lesion, disease activity of CD, and the presence of perianal lesion were analyzed with logistic regression model.
Results:Eighty-eight patients (54.7%) had EIMs. The main EIMs were immune-mediated EIMs and growth retardation, accounting for 41.0% (66/161) and 24.2% (39/161), respectively. Aphthous ulcer (39/161, 23.0%) was the most common symptom among immune-mediated EIMs, followed by arthropathy (20/161, 12.4%) and skin lesions (19/161, 11.8%). Forty-three patients (26.7%) had EIMs before being diagnosed as IBD. Fifty-eight (65.9%) patients had only one EIM during the whole course of IBD. By logistic regression analysis, CD (OR=5.536, 95%CI:1.825-16.788) and perianal disease (OR=1.969, 95%CI:1.035-3.746) were the risk factors of immune-mediated EIMs. Meanwhile, CD (OR=11.319, 95%CI: 1.487-86.179), younger than six-year-old at diagnosis (OR=8.556, 95%CI: 3.109-23.545), moderate to severe activity of CD (OR=3.447, 95%CI: 1.196-9.934) and perianal disease (OR=3.361, 95%CI: 1.720-7.793) increased the risk of growth retardation.
Conclusions:The children with IBD have a high incidence of EIMs, which were more common in CD than in UC. The risk factors of developing EIMs include CD, perianal diseases, younger than six-year-old at diagnosis and moderate to severe activity of CD.
