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Association of age at diagnosis and Crohn's disease phenotype.

ABSTRACT: fifteen percent of patients with Crohn's disease (CD) are elderly; they are less likely to have complications and more likely to have colonic disease.to compare disease behaviour in patients with CD based on age at diagnosis.cross-sectional study.tertiary referral centre.patients with confirmed CD.behaviour was characterised according to the Montreal classification. Patients with either stricturing or penetrating disease were classified as having complicated disease. Age at diagnosis was categorised as <17, 17-40, 41-59 and ? 60 years. Logistic regression analysis was performed to examine the association between advanced age ? 60 and complicated disease.a total of 467 patients were evaluated between 2004 and 2010. Increasing age of diagnosis was negatively associated with complicated disease and positively associated with colonic disease. As age of diagnosis increased, disease duration (P < 0.001), family history of Inflammatory bowel disease (IBD) (P = 0.015) and perianal disease decreased (P < 0.0015). After adjustment for confounding variables, the association between age at diagnosis and complicated disease was no longer significant (OR: 0.60, 95% CI: 0.21-1.65).patients diagnosed with CD ? 60 were more likely to have colonic disease and non-complicated disease. However, the association between age at diagnosis and complicated disease did not persist after adjustment for confounding variables.

SUBMITTER: Quezada SM

PROVIDER: S-EPMC3518904 | biostudies-other | 2013 Jan

REPOSITORIES: biostudies-other

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Association of age at diagnosis and Crohn's disease phenotype.

Quezada Sandra M SM Steinberger Eileen K EK Cross Raymond K RK

Age and ageing 20120822 1

<h4>Background</h4>fifteen percent of patients with Crohn's disease (CD) are elderly; they are less likely to have complications and more likely to have colonic disease.<h4>Objective</h4>to compare disease behaviour in patients with CD based on age at diagnosis.<h4>Design</h4>cross-sectional study.<h4>Setting</h4>tertiary referral centre.<h4>Subjects</h4>patients with confirmed CD.<h4>Methods</h4>behaviour was characterised according to the Montreal classification. Patients with either stricturi ...[more]

PMID: 22918090

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Project description:AimTo investigate genotype-phenotype correlations in patients with perianal Crohn's disease (PCD) in order to determine which factors predispose to development of perianal disease in Crohn's patients.MethodsSeven-hundred and ninety-five Caucasian individuals (317 CD patients and 478 controls without inflammatory bowel disease, IBD) were prospectively enrolled into a clinical/genetic database. Demographic and clinical data, as well as peripheral blood leukocyte DNA were obtained from all patients. The following were evaluated: three NOD2/CARD15 polymorphisms: R702W, G908R, and 1007insC; five IL-23r risk alleles: rs1004819, rs10489629, rs2201841, rs11465804, and rs11209026; a well-characterized single-nucleotide polymorphism (SNP) on the IBD5 risk haplotype (OCTN1) and two peripheral tag SNPs (IGR2060 and IGR3096).ResultsPCD occurred in 147 (46%) of CD patients. There was no significant difference in the age at disease diagnosis between non-PCD and PCD patients (33 vs. 29 years, respectively). PCD patients were more likely to have disease located in the colon and ileocolic regions (79 PCD vs. 57% non-PCD; n = 116 vs. n = 96; p < 0.001), whereas patients with non-PCD were more likely to have Crohn's within the terminal ileum and upper gastrointestinal tract (43% non-PCD vs. 21% PCD; n = 73 vs. n = 31; p < 0.05). Thirty-four percent of patients with PCD required a permanent ileostomy (n = 50) compared to only 4% of non-PCD patients (n = 6; p < 0.05). Mutations in CARD15/NOD2 and IL-23r were risk factors for CD overall; however, in contrast to prior reports, in this patient population, OCTN1 and IGR variations within the IBD5 haplotype were not significant predictors of PCD.ConclusionColon/ileocolic CD location appears to be a significant predictor of perianal manifestations of CD. Patients with PCD are more likely to require permanent fecal diversion. We did not identify any genetic variations or combination of clinical findings and genetic variations within the CARD15/NOD2, IL-23r, and OCTN1 genes or IGR that were predictive of PCD.

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Association of age at diagnosis and Crohn's disease phenotype.

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Association of age at diagnosis and Crohn's disease phenotype.

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