Incidence of inflammatory bowel disease in children in Brittany (1994-1997)

Background. - The aim of this work was to determine in Brittany the inciden ce and main clinical pattern of inflammatory bowel disease (IBD) occurring during childhood. These data are compared to the previous epidemiologic dat a available from the Northern France registry or around the world. Methods. - Private and public Brittany gastroenterologists (2,836,418 inhab itants including 618.049 children under 17 years of age) referred all patie nts consulting for inflammatory bowel disease from January 1994 to December 1997 An interviewer-practitioner completed at the gastroenterologist's off ice a standard questionnaire for each patient. Each case was independently reviewed by four experts in a blind manner and made a final diagnosis of Cr ohn's disease (CD), ulcerative colitis (UC) or ulcerative proctitis and acu te colitis (onset of symptoms < 6 weeks) or unclassified chronic colitis. Results. - Among 1,309 cases recorded, 88 were under 17 years of age (6.7%) : 43 (49%) had CD (including three possible cases), 14 (16%) had UC (includ ing three proctitis), 24 (27%) acute colitis and 7 (8%) unclassified chroni c colitis. The crude mean annual incidence (per 100,000 children) based on definite and probable cases only was 2.5 for IBD, 1.6 for CD and 0.57 for U C, without variation between 1994 and 1997. The male/female ratio was 2.3 f or CD and 1.3 for UC. The mean time between onset of disease and diagnosis was equal to 7.2 and 8.6 months for CD and UC respectively (median: 3 and 5 months). A familial history of IBD was present in 5 cases (8%). In CD, the small and large bowel were involved in 58% of patients, whereas an isolate d involvement of small or large bowel occurred in 15% and 23% of cases. Amo ng the 14 UC, there were three proctitis and four pancolitis. Among 43 CD, a granuloma was present in 48% of cases. Conclusions. - In Brittany the incidence of CD and UC in childhood was simi lar to the published data from Northern France. Clinical presentation and s ymptoms were not different. However, the rate of acute colitis was higher a nd the accurate incidence of IBD could be underestimated, requiring a follo w-up to classify these cases. (C) 2000 Editions scientifiques ef medicales Elsevier SAS.