Recent advance in very early-onset inflammatory bowel disease

Research output: Contribution to journalArticle

Abstract

Recent studies on pediatric inflammatory bowel disease (IBD) have revealed that early-onset IBD has distinct phenotypic differences compared with adult-onset IBD. In particular, very early-onset IBD (VEO-IBD) differs in many aspects, including the disease type, location of the lesions, disease behavior, and genetically attributable risks. Neonatal or infantile-onset IBD develops in less than 1% of pediatric patients. Children with infantile-onset IBD have high rates of affected first-degree relatives and severe disease course. The suspicion of a monogenic cause of VEO-IBD was first confirmed by the discovery of mutations in the genes encoding the interleukin 10 (IL-10) receptors that cause impaired IL-10 signaling. Patients with such mutations typically presented with perianal fistulae, shows a poor response to medical management, and require early surgical interventions in the first year of life. To date, 60 monogenic defects have been identified in children with IBD-like phenotypes. The majority of monogenic defects presents before 6 years of age, and many present before 1 year of age. Next generation sequencing could become an important diagnostic tool in children with suspected genetic defects especially in children with VEO-IBD with severe disease phenotypes. VEO-IBD is a phenotypically and genetically distinct disease entity from adult-onset or older pediatric IBD.

Original languageEnglish
Pages (from-to)9-16
Number of pages8
JournalIntestinal Research
Volume17
Issue number1
DOIs
Publication statusPublished - 2019 Jan 1

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Inflammatory Bowel Diseases
Pediatrics
Interleukin-10 Receptors
Phenotype
Mutation
Interleukin-10
Fistula
Genes

Keywords

  • Child
  • Infant
  • Mutation
  • Very early-onset inflammatory bowel disease

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Recent advance in very early-onset inflammatory bowel disease. / Shim, Jung Ok.

In: Intestinal Research, Vol. 17, No. 1, 01.01.2019, p. 9-16.

Research output: Contribution to journalArticle

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