Abstract
Background and aims
The aims of this study were to describe the trends in the behavior of pediatric CD
during the last decade and to describe the seasonal variation of disease presentation.
Methods
Patients under 18 years old and diagnosed between 2009 and 2019 were included. The
clinical, endoscopic, histological, and laboratory data were collected from the medical
records. We analyzed the trends of these parameters according to the year and season
of diagnosis.
Results
654 patients were included in the study. The number of incident CD cases increased
yearly. Patients diagnosed between 2015 and 2019 were younger at diagnosis (OR 2.53,
p = 0.02), had more perianal diseases (OR: 2.30, p < 0.0001) and more granulomas (OR: 1.61, p = 0.003), but fewer eosinophils (OR: 0.35, p < 0.0001) and less chronic lymphoplasmacytic infiltrate (OR: 0.56, p = 0.008) as compared to the 2009–2014 cohort. There was fewer CD diagnosis during
winter. Patients diagnosed in the fall had lower PCDAIs, less failure to thrive and
less extensive digestive involvement. Colonic disease was significantly more frequent
during summer and fall.
Conclusion
The clinical and histological phenotype of CD has changed over time and there are
important seasonal trends in the frequency and severity on disease behavior suggesting
possible disease triggers.
Keywords
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Article info
Publication history
Published online: October 27, 2021
Accepted:
September 10,
2021
Received:
July 1,
2021
Footnotes
Summary: Evolution in the clinical, endoscopic, histological, and laboratory characteristics of pediatric CD during the last decade and seasonal trends of disease presentation.
What's Know on This Subject: Crohn's disease is a multifactorial disease, associated with some genetic markers and environmental factors including diet, infections and gut microbiota and the incidence of CD has been increasing.
What This Study Adds: The disease phenotype has changed over time and there are important seasonal trends in disease presentation. Our findings provide interesting avenues for future research, such as identifying the clinical significance of granuloma, vitamin D deficiency and microbiota in pediatric Crohn's disease.
Identification
Copyright
© 2021 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
