P222 Extraintestinal manifestations in paediatric-onset inflammatory bowel disease depending on disease location and activity

• Published in: Journal of Crohn's and colitis Vol. 14; no. Supplement_1; pp. S253 - S254
• Main Authors: Grzybowska-Chlebowczyk, U E, Buczyńska, A, Niewiem, M, Flak-Wancerz, A, Kałużna-Czyż, M, Więcek, S
• Format: Journal Article
• Language: English
• Published: US Oxford University Press 15.01.2020
• DOI: 10.1093/ecco-jcc/jjz203.351
• ISSN: 1873-9946

Abstract Background Inflammatory bowel disease (IBD) and its major forms, i.e. Crohn’s disease (CD) and ulcerative colitis (UC), have systemic implications, which, as suggested by Vavricka et al., can be divided into extraintestinal manifestations (EIM) directly related to immune mechanisms and non-immune extraintestinal complications resulting from malabsorption. Extraintestinal manifestations may develop prior to or after IBD diagnosis. The aim of the study was to determine the prevalence and types of extraintestinal manifestations (EIMs) in paediatric-onset inflammatory bowel diseases (IBD), i.e., Crohn’s disease (CD) and ulcerative colitis (UC), depending on disease activity and location, and to determine whether the presence of EIM is associated with a distinctive clinical course of IBD. Methods The medical records of 336 children with IBD with or without EIMs were retrospectively analysed, especially regarding the following characteristics: age at diagnosis, clinical symptoms, nutritional status, the Paris Classification, and IBD activity. The diagnosis was made based on the revised Porto criteria. The medical histories of patients and data obtained in physical examinations were analysed, especially the following: (a) anthropometric measurements for nutritional status assessment based on percentile charts of the OLAF study, (b) disease activity using the PCDAI and the PUCAI, disease location and type according to the Paris classification. Results The study population of 336 children comprised 175 patients with UC and 161 patients with CD. EIMs were diagnosed in 65 patients (19%). The most frequent immune-related EIM in UC patients was primary sclerosing cholangitis (PSC); the collective proportion of PSC and PSC/autoimmune hepatitis (AIH) was 13,7% of UC patients. Arthropathy was the most prevalent EIM in the subpopulation of CD participants (8,6%). Pancolitis was a risk factor for EIMs in the UC and especially for PSC and AIH/PSC. We also analysed the population for correlation in presented symptoms pattern in patients EIM(+) vs. EIM(-) as well as differences in age and sex distribution and IBD activity, location and behaviour. Conclusion EIMs are a significant issue in the population of children with IBD; they developed in 19% of our patients. Determination of the prevalence of these manifestations and related risk factors might raise awareness of the problem and facilitate diagnosis and therapy.