Pediatr Gastroenterol Hepatol Nutr.  2022 May;25(3):218-227. 10.5223/pghn.2022.25.3.218.

Pediatric Inflammatory Bowel Disease: A Multicenter Study of Changing Trends in Argentina Over the Past 30 Years

Affiliations
  • 1Pediatric Gastroenterology, Hepatology and Liver Intestinal Transplantation Unit, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
  • 2Pediatric Gastroenterology Service, Hospital de Pediatría S.A.M.I.C. “Prof. Dr. Juan P. Garrahan”, Buenos Aires, Argentina
  • 3Pediatric Gastroenterology Service, Hospital de Niños, Dr. Ricardo Gutierrez, Buenos Aires, Argentina
  • 4Pediatric Service, Hospital Privado de la Comunidad, Buenos Aires, Argentina

Abstract

Purpose
To analyze the characteristics of pediatric inflammatory bowel disease (IBD) over the past three decades in Argentina and determine if there are differences between the first two decades and the past decade.
Methods
We conducted a retrospective multicenter analytical study in children with IBD between 0 and 18 years of age diagnosed between 1987 and 2017 in three tertiary health centers in Argentina. The evaluation included clinical characterization, endoscopy, histology, and imaging data together with therapeutic strategies. The patients were divided into two groups: Group 1, diagnosed between 1987 and 2007, and Group 2, diagnosed between 2008 and 2017.
Results
Of the 756 patients included, 409 (54%) had ulcerative colitis (UC), 250 (33%) had Crohn’s disease (CD), and 97 (13%) had IBD-unclassified (IBD-U). The positive family history was 3.8%, which was more frequent among children under two years of age (6.7%). There were no significant differences in clinical presentation and extraintestinal manifestations between periods, with hepatic manifestations being the most frequent. In the last decade, we found an upward trend in CD, a downward trend in UC/IBD-U, even after adjustment for socioeconomic status, and a decrease of 50% in surgical treatments coinciding with the advent of biological therapy.
Conclusion
This is the first multicenter cohort study in a Latin American country to describe clinical, endoscopic, and therapeutic data across the past 30-year period. Although CD was responsible for the overall increase in incidence, UC was still prevalent in this region.

Keyword

Crohn disease; Ulcerative colitis; Inflammatory bowel disease
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