Incidence rates and disease course of paediatric inflammatory bowel diseases in Western Hungary between 1977 and 2011

Dig Liver Dis. 2014 May;46(5):405-11. doi: 10.1016/j.dld.2013.12.013. Epub 2014 Feb 1.

Abstract

Background: Limited data are available on paediatric inflammatory bowel diseases in Eastern Europe. Our aim was to analyse disease characteristics in the population-based Veszprem province database between 1977 and 2011.

Methods: 187 (10.5%, ulcerative colitis/Crohn's disease/undetermined colitis: 88/95/4) out of 1565 incident patients were diagnosed with a paediatric onset in this population-based prospective inception cohort.

Results: The incidence of Crohn's disease and ulcerative colitis increased from 0 and 0.7 in 1977-1981 to 7.2 and 5.2 in 2007-2011 per 100,000 person years. Ileocolonic location (45%) and inflammatory disease behaviour (61%) were most frequent in Crohn's disease, while azathioprine use was frequent (66%) and surgical resection rates were high (33% at 5 years) in cases with paediatric onset. In ulcerative colitis, 34% of patients were diagnosed with extensive disease, with high rates of disease extension (26% and 41% at 5 and 10 years), fulminant episodes (19.3%) and systemic steroid use (52.3%). The cumulative rate of colectomy was low (6.9%).

Conclusions: The incidence of paediatric inflammatory bowel diseases has rapidly increased in the last three decades in Western Hungary. Ileocolonic disease and a need for azathioprine were characteristic in paediatric Crohn's disease, while paediatric onset ulcerative colitis was characterised by extensive disease and disease extension, while the need for colectomy was low.

Keywords: Crohn's disease; Disease course; Disease phenotype; Incidence; Paediatric; Ulcerative colitis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Age Factors
  • Anti-Inflammatory Agents / therapeutic use
  • Azathioprine / therapeutic use
  • Child
  • Child, Preschool
  • Colectomy / statistics & numerical data
  • Colitis, Ulcerative / epidemiology*
  • Colitis, Ulcerative / therapy
  • Crohn Disease / epidemiology*
  • Crohn Disease / therapy
  • Female
  • Humans
  • Hungary / epidemiology
  • Immunosuppressive Agents / therapeutic use
  • Incidence
  • Infant
  • Infant, Newborn
  • Male
  • Phenotype
  • Severity of Illness Index
  • Sex Factors
  • Steroids / therapeutic use

Substances

  • Anti-Inflammatory Agents
  • Immunosuppressive Agents
  • Steroids
  • Azathioprine