A characterization in childhood inflammatory bowel disease, a new population-based inception cohort from South-Eastern Norway, 2005-07, showing increased incidence in Crohn's disease.

Authors:
Gøri Perminow, Stephan Brackmann, Lars G Lyckander, Andre Franke, Arne Borthne, Andreas Rydning, Geir Aamodt, Stefan Schreiber, Morten H Vatn, - -
Year of publication:
2009
Volume:
44
Issue:
4
Issn:
0036-5521
Journal title abbreviated:
SCAND J GASTROENTERO
Journal title long:
Scandinavian journal of gastroenterology
Impact factor:
2.199
Abstract:
Owing to rising incidence rates in inflammatory bowel disease (IBD), there has been increased interest in causal relationships in pediatric disease. The present population-based inception cohort was recruited in the Oslo area from 2005 to 2007, with the aim of conducting a detailed characterization of treatment-naive patients at diagnosis.After an invitation was extended to all general practitioners in the catchment area, patients aged <18 years with suspected IBD were diagnosed by proximal and distal endoscopy, MRI, demographic, clinical, and histological and molecular characteristics. Symptomatic non-IBD patients served as controls.Of 100 pediatric patients, 62 had IBD (39 Crohn''s disease (CD), 19 ulcerative colitis (UC), 4 IBD unclassified (IBDU)) and 38 other diseases. Median age at diagnosis for IBD was 13.1 years (56.4% males), median symptom duration 6 months, and 69% L3 (Vienna classification). With 195,000 children aged <18 years in the catchment area, the incidence rate of IBD per 100,000/years inhabitants was 10.9 (6.8 for CD, 3.6 for UC, and 0.6 IBDU) and for those aged <16 years (178,500) the incidence rate was 10.6. The higher NOD2 allele frequency among children may partly contribute to the increase.The results indicate a marked rise in the incidence of CD in contrast to no increase in UC in South-Eastern Norway, compared with the figures from the last 15 years. Time from onset of symptoms to diagnosis still represents a challenge for early characterization in IBD.