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Clinical Features and Natural History of Paediatric Patients with Ulcerative Proctitis: A Multicentre Study from the Paediatric IBD Porto Group of ESPGHAN
N. Tal, C. Tzivinikos, M. Gasparetto, DE. Serban, E. Zifman, I. Hojsak, O. Ledder, A. Yerushalmy Feler, H. Rolandsdotter, M. Aloi, M. Bramuzzo, S. Buderus, P. Lionetti, L. Norsa, C. Norden, D. Urlep, C. Romano, R. Shaoul, C. Martinez-Vinson, A....
Jazyk angličtina Země Anglie, Velká Británie
Typ dokumentu kazuistiky, multicentrická studie, časopisecké články
PubMed
37392064
DOI
10.1093/ecco-jcc/jjad111
Knihovny.cz E-zdroje
- MeSH
- biologické přípravky * terapeutické užití MeSH
- dítě MeSH
- idiopatické střevní záněty * farmakoterapie MeSH
- lidé MeSH
- mladiství MeSH
- proktitida * diagnóza etiologie MeSH
- retrospektivní studie MeSH
- ulcerózní kolitida * komplikace diagnóza farmakoterapie MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- mladiství MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
- multicentrická studie MeSH
BACKGROUND AND AIMS: Ulcerative proctitis [UP] is an uncommon presentation in paediatric patients with ulcerative colitis. We aimed to characterize the clinical features and natural history of UP in children, and to identify predictors of poor outcomes. METHODS: This was a retrospective study involving 37 sites affiliated with the IBD Porto Group of ESPGHAN. Data were collected from patients aged <18 years diagnosed with UP between January 1, 2016 and December 31, 2020. RESULTS: We identified 196 patients with UP (median age at diagnosis 14.6 years [interquartile range, IQR 12.5-16.0]), with a median follow-up of 2.7 years [IQR 1.7-3.8]. The most common presenting symptoms were bloody stools [95%], abdominal pain [61%] and diarrhoea [47%]. At diagnosis, the median paediatric ulcerative colitis activity index [PUCAI] score was 25 [IQR 20-35], but most patients exhibited moderate-severe endoscopic inflammation. By the end of induction, 5-aminosalicylic acid administration orally, topically or both resulted in clinical remission rates of 48%, 48%, and 73%, respectively. The rates of treatment escalation to biologics at 1, 3, and 5 years were 10%, 22%, and 43%, respectively. In multivariate analysis, the PUCAI score at diagnosis was significantly associated with initiation of systemic steroids, or biologics, and subsequent acute severe colitis events and inflammatory bowel disease-associated admission, with a score ≥35 providing an increased risk for poor outcomes. By the end of follow-up, 3.1% of patients underwent colectomy. Patients with UP that experienced proximal disease progression during follow-up [48%] had significantly higher rates of a caecal patch at diagnosis and higher PUCAI score by the end of induction, compared to those without progression. CONCLUSION: Paediatric patients with UP exhibit high rates of treatment escalation and proximal disease extension.
Children's Health Ireland UCD and RCSI Dublin Ireland
Children's Hospital University of Helsinki Helsinki Finland
Department NEUROFARBA University of Florence Meyer Children's Hospital Florence Italy
Department of Clinical Science and Education Södersjukhuset Karolinska Institutet Stockholm Sweden
Department of Pediatric Gastroenterology Great North Children's Hospital Newcastle UK
Department of Pediatrics Hvidovre University Hospital Copenhagen Hvidovre Denmark
Department of Pediatrics School of Medicine Kyungpook National University Daegu Korea
Department of Pediatrics St Marien Hospital Bonn Germany
Faculty of Medicine and Health Technology University of Tampere Tampere Finland
Faculty of Medicine Tel Aviv University Tel Aviv Israel
Gastroenterology and Nutrition Department Hospital Infantil Universitario Niño Jesús Madrid Spain
Heim Pál National Pediatric Institute Budapest Hungary
Institute for Maternal and Child Health IRCCS 'Burlo Garofolo' Trieste Italy
Pediatric Gastroenterology Hepatology and Nutrition Institute Sapienza University of Rome Rome Italy
Pediatric Gastroenterology Unit Emek Medical Center Afula Israel
Pediatric Gastroenterology Unit Maggiore Hospital Bologna Italy
Pediatric Gastroenterology Unit Meir Medical Center Kfar Saba Israel
Sachs' Children and Youth Hospital Department of Gastroenterology Södersjukhuset Stockholm Sweden
Citace poskytuje Crossref.org
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