Inflammatory bowel disease in Turkish children
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Date
2015
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Abstract
Background: This study was undertaken to evaluate demographics, clinical manifestations, laboratory findings and outcomes of children with inflammatory bowel disease (IBD) in Turkey. Methods: We analyzed the medical records of 127 children diagnosed with IBD (under 18 years old) between January 2004 and January 2012 in 8 pediatric gastroenterology centers. Results: Of the 127 patients, 90 (70.9%) suffered from ulcerative colitis (UC), 29 (22.8%) from Crohn’s disease (CD), and 8 (6.3%) from IBD unclassified. The mean age of the 127 patients was 11.6±4.1 years, and 11.8% of the patients were below 5 years old. Of the patients, 49.6% were male, and males were more predominant in patients with CD than in those with UC (72.4% vs. 42.2%, P=0.008; a male/female ratio of 2.62 in CD, P=0.0016). Approximately one fifth of the patients had extra-intestinal manifestations and 13.3% of the patients had associated diseases. Extraintestinal manifestations and associated diseases were more common in early onset disease [P=0.017, odds ratio (OR)=4.02; P=0.03, OR=4.1]. Of the patients, 15% had normal laboratory parameters including anemia, high platelet count, hypoalbuminemia, hypoferritinemia, and high sedimentation rate. Area under receiver operation characteristics was used to predict pancolitis in patients with UC. The values of C-reactive protein, sedimentation rate and pediatric ulcerative colitis activity were 0.61 (P=0.06), 0.66 (P=0.01) and 0.76 (P=0.0001), respectively. Four (4.4%) patients with UC underwent colectomy, and finally two (1.5%, 95% confidence interval: 0-3.7%) patients died from primary disease or complications. Conclusions: IBD is an increasing clinical entity in Turkey. Features of IBD are similar to those in other populations, but prospective multicenter studies are needed to analyze the true incidence of IBD in Turkish children. © 2015, Children's Hospital, Zhejiang University School of Medicine and Springer-Verlag Berlin Heidelberg.
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Keywords
Adolescent , Biopsy , Child , Child, Preschool , Colonoscopy , Female , Humans , Infant , Inflammatory Bowel Diseases , Male , Retrospective Studies , Turkey , alanine aminotransferase , aminosalicylic acid , azathioprine , C reactive protein , corticosteroid , cyclosporin , methotrexate , tumor necrosis factor alpha inhibitor , abdominal pain , abnormally low substrate concentration in blood , anatomic landmark , anemia , Article , child , childhood obesity , clinical feature , colon resection , consanguinity , Crohn disease , Crohn Disease Activity Index , cyanocobalamin deficiency , demography , diarrhea , digestive system disease assessment , erythema nodosum , familial Mediterranean fever , family history , female , folic acid deficiency , human , hypertransaminasemia , hypoalbuminemia , hypocalcemia , hypoferritinemia , immunoglobulin deficiency , inflammatory bowel disease , inflammatory bowel disease unclassified , inflammatory bowel disease unclassified , intestine fistula , leukocytosis , maintenance therapy , major clinical study , male , malnutrition , nephrolithiasis , pancolitis , pediatric ulcerative colitis activity index , rectum hemorrhage , retrospective study , sclerosing cholangitis , sedimentation rate , sensitivity and specificity , short stature , thrombocyte count , Turkey (republic) , ulcerative colitis , uveitis , adolescent , biopsy , colonoscopy , complication , infant , Inflammatory Bowel Diseases , preschool child , Turkey