Childhood onset of Crohn disease: experience from a university teaching hospital in Saudi Arabia

BACKGROUND AND OBJECTIVES: Crohn disease (CD) is an increasingly recognized problem in Saudi Arabia. The aim of this study was to describe the clinical pattern in children and adolescents with CD seen at King Abdulaziz University Hospital (KAUH), Jeddah, Saudi Arabia. DESIGN AND SETTING: Retrospective hospital-based study conducted on data collected for the period between January 2001 and March 2010. PATIENTS AND METHODS: Data for all children and adolescents diagnosed at KAUH with CD in the period were retrieved and analyzed. RESULTS: Ninety-six patients were identified. The median age at diagnosis was 11.3 years (range, 0.12–17.6 years). Fifty (52.1%) were males. Sixty-four (66.7%) were Saudis. Nine (9.4%) had a first degree relative with inflammatory bowel disease. The most common presenting symptoms were diarrhea (88.5%), weight loss (84.2%) and anorexia (80.2%). At least one extraintestinal manifestation occurred in 24% of patients. Forty-two percent were underweight and 19% had short stature. The most common distribution was ileocolonic (37.5%), followed by colonic in 31.2%. Twenty-five (26%) patients had perianal disease, 13 (13.5%) had strictures and 15 (15.6%) had penetrating disease. Laboratory investigations revealed anemia in 84.4%, thrombocytosis in 50%, hypoalbuminemia in 64.6%, elevated erythrocyte sedimentation rate (ESR) in 50% and elevated C-reactive protein in 58.3%. Induction of remission was achieved with enteral nutrition in 20% of patients and with corticosteroids in the remaining. CONCLUSIONS: The clinical pattern of CD in children from the Western Province of Saudi Arabia was found to be similar to reports from the West. Pediatricians should be aware of the varying presentations of CD. Early referral to specialized centers is crucial.