Journal of pediatric gastroenterology and nutrition · 2026
Risk of Crohn's disease in children presenting with perianal abscess and fistula increases with age: A multicenter study.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
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Roskam Mariëlle, Dierikx Thomas, Hulsmann Sanne, Lemmen Jesse, Leijdekkers Vanessa, Luttikhold Joanna, Garssen Frank, Dunker Mich, van der Bilt Jarmila, de Jong Justin, van Heurn Ernst, de Boer Nanne, Bakx Roel, de Meij Tim
Аннотация
OBJECTIVES: Perianal abscesses (PA) and fistulas-in-ano (FIA) are frequently diagnosed in children and may be presenting symptoms of Crohn's disease (CD). The association between age at presentation of PA/FIA and the risk of subsequent CD development is largely unknown. Aim of this study was to investigate the association between PA/FIA and risk for CD development, stratified by age.
METHODS: In this retrospective multicenter study children between 2 and 18 years presenting with PA/FIA, were included. Patient characteristics, biochemical data, and data on CD development were collected. The risk of developing IBD was stratified by age in three subgroups (<6, 6-12, and 12-18 years).
RESULTS: One hundred and fifty-two children with PA/FIA were included (78% male; median age 11.1 years; interquartile range [IQR]: 8.0), of whom 32 (21.1%) were diagnosed with CD. Children aged 12-18 years (n = 23; 32.4%) were more often diagnosed with CD compared to the subgroup 6-12 years (n = 8; 15.1%) odds ratio (OR) 2.09; p = 0.03) and the subgroup 2-6 years (n = 1; 3.6%; OR 14.24; p = 0.01). Recurrent PA/FIA (OR 3.20; p = 0.005) and typical inflammatory bowel disease (IBD)-associated symptoms (OR 4.85; p < 0.001) were significantly associated with CD development. Median value of elevated fecal calprotectin (FCP) was significantly higher in the CD group (1212 µg/g) than in the non-CD group (22.5 µg/g; p < 0.001).
CONCLUSIONS: The overall risk of developing CD in children presenting with PA/FIA was 21%, this risk was age dependent. Our findings emphasize the need for high awareness by physicians in children presenting with PA/FIA for the development of CD, also in the years following first presentation, particularly when aged ≥6 years.
METHODS: In this retrospective multicenter study children between 2 and 18 years presenting with PA/FIA, were included. Patient characteristics, biochemical data, and data on CD development were collected. The risk of developing IBD was stratified by age in three subgroups (<6, 6-12, and 12-18 years).
RESULTS: One hundred and fifty-two children with PA/FIA were included (78% male; median age 11.1 years; interquartile range [IQR]: 8.0), of whom 32 (21.1%) were diagnosed with CD. Children aged 12-18 years (n = 23; 32.4%) were more often diagnosed with CD compared to the subgroup 6-12 years (n = 8; 15.1%) odds ratio (OR) 2.09; p = 0.03) and the subgroup 2-6 years (n = 1; 3.6%; OR 14.24; p = 0.01). Recurrent PA/FIA (OR 3.20; p = 0.005) and typical inflammatory bowel disease (IBD)-associated symptoms (OR 4.85; p < 0.001) were significantly associated with CD development. Median value of elevated fecal calprotectin (FCP) was significantly higher in the CD group (1212 µg/g) than in the non-CD group (22.5 µg/g; p < 0.001).
CONCLUSIONS: The overall risk of developing CD in children presenting with PA/FIA was 21%, this risk was age dependent. Our findings emphasize the need for high awareness by physicians in children presenting with PA/FIA for the development of CD, also in the years following first presentation, particularly when aged ≥6 years.