Published online Dec 28, 2016. doi: 10.3748/wjg.v22.i48.10653
Peer-review started: March 8, 2016
First decision: April 14, 2016
Revised: August 31, 2016
Accepted: October 19, 2016
Article in press: October 19, 2016
Published online: December 28, 2016
Infantile-onset inflammatory bowel disease (IO-IBD) with the onset of disease before 12 mo of age, is a different disease entity from childhood IBD. We aimed to describe the clinical features, outcome and role of mutation in interleukin-10 (IL-10) and interleukin-10 receptors (IL-10R) in Asian children with IO-IBD.
All cases of IO-IBD, defined as onset of disease before 12 mo of age, seen at University Malaya Medical Center, Malaysia were reviewed. We performed mutational analysis for IL10 and IL10R genes in patients with presenting clinical features of Crohn’s disease (CD).
Six [13%; CD = 3, ulcerative colitis (UC) = 2, IBD-unclassified (IBD-U) = 1] of the 48 children (CD = 25; UC = 23) with IBD have IO-IBD. At final review [median (range) duration of follow-up: 6.5 (3.0-20) years], three patients were in remission without immunosuppression [one each for post-colostomy (IBD-U), after standard immunosuppression (CD), and after total colectomy (UC)]. Three patients were on immunosuppression: one (UC) was in remission while two (both CD) had persistent disease. As compared with later-onset disease, IO-IBD were more likely to present with bloody diarrhea (100% vs 55%, P = 0.039) but were similar in terms of an associated autoimmune liver disease (0% vs 19%, P = 0.31), requiring biologics therapy (50% vs 36%, P = 0.40), surgery (50% vs 29%, P = 0.27), or achieving remission (50% vs 64%, P = 0.40). No mutations in either IL10 or IL10R in the three patients with CD and the only patient with IBD-U were identified.
The clinical features of IO-IBD in this Asian cohort of children who were negative for IL-10 or IL-10R mutations were variable. As compared to childhood IBD with onset of disease after 12 mo of age, IO-IBD achieved remission at a similar rate.
Core tip: We described the clinical features, outcome and role of mutation in IL-10 and IL-10R in Asian children with infantile-onset inflammatory bowel disease (IO-IBD). We reviewed all cases of IO-IBD, defined as onset of disease before 12 mo of age, seen at a single center in Malaysia. We conclude that the clinical features of IO-IBD in this Asian cohort of children were variable. IO-IBD achieved remission at a similar rate, were more likely to discontinue immunosuppression therapy at final review and not more likely to require biologics therapy or surgery.