The natural history of Crohn's disease in children: A review of population-based studies

Dana Duricova, Mathurin Fumery, Vito Annese, P. Lakatos, Laurent Peyrin-Biroulet, Corinne Gower-Rousseau

Research output: Contribution to journalReview article

32 Citations (Scopus)

Abstract

The incidence of Crohn's disease (CD) has been reported to increase. The aim of this review is to perform a comprehensive literature search of population-based studies focused on the natural history of paediatric-onset CD. A literature search of English and non-English language publications listed in the electronic database of MEDLINE (source PUBMED) and EMBASE from 1935 to 2016 was performed. Population-based studies or national cohorts reporting data on the short-term or long-term disease course of paediatric CD were included. Forty-nine paediatric and 15 nonpaediatric studies on CD have been identified. Up to onethird of children with inflammatory behaviour developed bowel complications more than 5 years after diagnosis. From 48 to 88% of children have experienced at least one corticosteroid course irrespective of the period of diagnosis and up to one-third became steroid dependent. Immunosuppressive preparations were used earlier and more frequently in newer than older cohorts (68 vs. 32% at 5 years) and more than one-third of children have received biological treatment early in the disease course. A decline in the surgery rate might be observed in more recent compared with older unselected populations. The relative risk of cancer in childhood-onset CD as well as the risk of death seem to have increased. Childhood-onset CD seems to be an aggressive phenotype of the disease. Compared with older cohorts, a trend towards decreasing surgical rate can be observed in newer cohorts paralleled by an increase in immunomodulator use and biologicals. Nevertheless, the causative role has yet to be investigated.

Original languageEnglish
Pages (from-to)125-134
Number of pages10
JournalEuropean Journal of Gastroenterology and Hepatology
Volume29
Issue number2
DOIs
Publication statusPublished - Jan 1 2017

Fingerprint

Crohn Disease
Population
Immunologic Factors
Immunosuppressive Agents
Natural History
MEDLINE
Publications
Adrenal Cortex Hormones
Research Design
Language
Steroids
Databases
Pediatrics
Phenotype
Incidence
Neoplasms
Pediatric Crohn's disease
Therapeutics

Keywords

  • Crohn's disease
  • Epidemiology
  • Inflammatory bowel disease
  • Paediatrics

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

Cite this

The natural history of Crohn's disease in children : A review of population-based studies. / Duricova, Dana; Fumery, Mathurin; Annese, Vito; Lakatos, P.; Peyrin-Biroulet, Laurent; Gower-Rousseau, Corinne.

In: European Journal of Gastroenterology and Hepatology, Vol. 29, No. 2, 01.01.2017, p. 125-134.

Research output: Contribution to journalReview article

Duricova, Dana ; Fumery, Mathurin ; Annese, Vito ; Lakatos, P. ; Peyrin-Biroulet, Laurent ; Gower-Rousseau, Corinne. / The natural history of Crohn's disease in children : A review of population-based studies. In: European Journal of Gastroenterology and Hepatology. 2017 ; Vol. 29, No. 2. pp. 125-134.
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