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P346. Profile of Belgian pediatric Crohn's disease patients: Presentation and diagnostic features

E. De Greef1,2, I. Hofman3, F. Smets4, S. Van Biervliet5, M. Scaillon6, B. Hauser2, I. Paquot7, P. Alliet8, W. Arts9, O. Dewit4, H. Peeters5, F. Baert10, G. D'Haens11, J.F. Rahier12, I. Etienne13, O. Bauraind14, A. Van Gossum15, S. Vermeire3, F. Fontaine16, V. Muls17, E. Louis18, F. Van de Mierop19, J.C. Coche14, J.J.M. Mahachie20, G. Veereman1,2

1Queen Paola Children's Hospital, Antwerp, Belgium; 2UZ Brussels, Brussels, Belgium; 3UZ Gasthuisberg, Leuven, Belgium; 4UCL St Luc, Brussels, Belgium; 5UZ Gent, Gent, Belgium; 6Hôpital des enfants Reine Fabiola, Brussels, Belgium; 7CHC Clinique de l'Esperance, Liège, Belgium; 8Jessa Hospital, Hasselt, Belgium; 9ZOL, Genk, Belgium; 10H Hart Hospital, Roesselare, Belgium; 11Imelda Hospital, Bonheiden, Belgium; 12UCL, Mont Godinne, Belgium; 13CHR de la Citadelle, Liège, Belgium; 14Clinique St Pierre, Ottignies, Belgium; 15ULB Erasme, Brussels, Belgium; 16CHU St Joseph, Liège, Belgium; 17CHU St Pierre, Brussels, Belgium; 18CHU Sart Tilman, Liège, Belgium; 19St Augustinus Hospital, Antwerp, Belgium; 20Montefiore Institute, ULG, Liège, Belgium

Objective: A Belgian Registry for pediatric Crohn's Disease (BELCRO) was created in order to estimate incidence and describe disease presentation and phenotype.

Methods: Previously and newly diagnosed CD patients under 18 yrs were recruited over a 2 y period (5, 2008 – 4, 2010) from 22 Belgian pediatric and adult centers after obtaining informed consent. Demographic and descriptive data were recorded.

Results: Of the 256 included patients, 68 were newly diagnosed: estimated incidence 1.4/105 children <18 y/year. In 70.2% the diagnosis was made by a paediatric gastroenterologist, in 51.4% in a university center. Subject's characteristics: 55% boys, 95.6% Caucasian, median age at diagnosis was 12.5 y (range 1.6–18). Neonatal data: median birth weight 3.3 kg (1.4–4.6 kg), median gestational age 40 wks (28–44 w), caesarian section in 12.6%, breast feeding in 78.1% for a median duration of 7 wks (0–140 w). In the 3 mths prior to diagnosis, 23.6% had a course of antibiotics, 22.9% suffered an infectious episode and 23.4% experienced a major stressful event. In 42.5% surgery was performed in the past; 1.1% were active, 16.4% passive smokers. Food allergy was present in 16% with 17.9% on diet restrictions. Median duration of symptoms before diagnosis was 3 m (1–12 m). Patients presented with diarrhea (72.4%), abdominal pain (84.1%), weight loss (72.6%) and growth retardation (51.7%) (median z-score for height: −1.04 (−6.74 to 2.07). Furthermore, extra intestinal manifestations were present in 24.9%, perianal disease in 28.0%, concomitant conditions in 28.2% and family history was positive for AI disease in 35.9%, for CD in 21.9% and for UC in 5.5%.

Montreal/Paris classification for disease location
 Disease location
 L1L2L3L4L4AL4B
Total Cohort (n = 256)336215617914483
Not evaluated12005620
<6 y (n = 10)343882
6–11 y (n = 91)72458665631
12–18 y (n = 154)2334941048049
Montreal/Paris classification for PCDAI
 PCDAI
 ≤10>10–≤30>30missing
Total Cohort (n = 256)1012111610
<6 y (n = 10)0730
6–11 y (n = 91)242461
12–18 y (n = 155)772679

Conclusion: Pediatric CD patients present with extensive disease and frequent upper GI involvement. Medical history prior to diagnosis is unremarkable but family history is frequently positive for auto-immune disease or IBD.