Outcome of childhood ulcerative colitis at 2 years

• Published in: Acta Paediatrica Vol. 96; no. 12; pp. 1790 - 1793
• Main Authors: Howarth, LJ, Wiskin, AE, Griffiths, DM, Afzal, NA, Beattie, RM
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.12.2007; Blackwell
• Subjects: Adolescent; Anti-Inflammatory Agents, Non-Steroidal - therapeutic use; Azathioprine; Azathioprine - therapeutic use; Biological and medical sciences; Child; Child, Preschool; Colectomy - statistics & numerical data; Colitis, Ulcerative - complications; Colitis, Ulcerative - diagnosis; Colitis, Ulcerative - physiopathology; Colitis, Ulcerative - therapy; Combined Modality Therapy; Corticosteroids; Female; Follow-Up Studies; Gastroenterology. Liver. Pancreas. Abdomen; General aspects; Glucocorticoids - therapeutic use; Growth; Hospitalization - statistics & numerical data; Humans; Immunosuppressive Agents - therapeutic use; Male; Medical sciences; Mesalamine - therapeutic use; Other diseases. Semiology; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; Surgery; Ulcerative colitis; Human; Corticosteroid; Pediatrics; Prognosis; Corticosteroids; Thiopurine derivatives; Inflammatory disease; Treatment; Surgery; Digestive diseases; Intestinal disease; Evolution; Immunosuppressive agent; Azathioprine; Child; Ulcerative colitis
• ISSN: 0803-5253; 1651-2227
• DOI: 10.1111/j.1651-2227.2007.00515.x

Aim: Ulcerative Colitis (UC) has an incidence of 1.4 per 100 000 in childhood. There is a paucity of data regarding outcome particularly with the increased use of early immunosuppression. This study reviews outcome at 2 years in a cohort with UC referred to a single centre. Method: Patients were recruited on the basis of a diagnosis made between 2000 and 2003 as a consecutive cohort. All had UC according to standard clinicopathological criteria. Children with indeterminate colitis were excluded. Follow‐up data was collected at 2 years by case notes review. Results: Thirty‐two children are reported. The median age at diagnosis was 11 years (range 2–16). All were treated with corticosteroids and 5‐ASA derivatives at diagnosis. The majority of patients (94%, 30/32) received more than one course of steroids. By 2 years azathioprine use was high with 75% (24/32) of patients on treatment for steroid‐dependent disease. There were 6 extra‐intestinal manifestations and 8 disease related complications occurring in 12 patients (38%). The colectomy rate was 9% (3/32) for unresponsive disease. Conclusion: There is a high need for Azathioprine in childhood UC. Colectomy rate at 2 years was around 10%. Extra‐intestinal manifestations and disease related complications are common.