Clinical features and outcomes of perianal disease in pediatric-onset Crohn’s disease: A comparative analysis according to age at diagnosis
- 1Department of Gastroenterology, Capital Center for Children’s Health, Capital Medical University, Beijing, 100020 China
Abstract
Background: This study aimed to investigate the clinical features, treatment responses, and outcomes of pediatric patients with Crohn’s disease (CD) and perianal disease (PD) in China, with a particular focus on age at diagnosis.
Methods: We retrospectively analyzed 144 children diagnosed with CD between 2015 and 2024. Patients were divided into PD and non-PD groups and further stratified by age at diagnosis into very-early onset (VEO-IBD, < 6 years) and late-onset disease (LO; 6–18 years). The clinical, endoscopic, and genetic data were compared between the groups.
Results: The overall prevalence of PD was 57/144 (39.58%). VEO-IBD cases accounted for 44/144 (30.56%) of cases, of whom 22/44 (50.00%) had concurrent PD; among these VEO-PD patients, the monogenic mutation rate was 17/22 (77.27%), predominantly involving IL-10RA. In the full cohort, PD was associated with increased colonic involvement (25/57 [43.86%] vs. 17/87 [19.54%], P < 0.05), greater disease severity (severe PCDAI: 25/57 [43.86%] vs. 20/87 [22.99%], P < 0.05), and lower clinical remission rates (41/57 [71.93%] vs. 83/87 [95.40%], P < 0.05). In the LO subgroup, patients with PD were treated with biologic agents significantly earlier, with clinical remission of perianal lesions reaching 30/35 (85.71%).
Conclusions: VEO-IBD with PD was associated with monogenic mutations, greater disease activity, and lower clinical remission. VEO-PD had poorer outcomes than VEO-IBD without PD, although mortality was similar. In selected monogenic VEO-IBD patients, thalidomide and/or HSCT may be individualized options, but thalidomide should not be generalized to all VEO-IBD.
Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12876-026-05485-y.
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BibTeX
@article{mi2026clinical,
title = {{Clinical features and outcomes of perianal disease in pediatric-onset Crohn’s disease: A comparative analysis according to age at diagnosis}},
author = {Mingran Mi and Meng Jin and Li Meng and Youzhe Gong and Xuemei Zhong},
journal = {BMC Gastroenterology},
year = {2026},
month = nov,
doi = {10.1186/s12876-026-05485-y},
url = {https://doi.org/10.1186/s12876-026-05485-y},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Clinical features and outcomes of perianal disease in pediatric-onset Crohn’s disease: A comparative analysis according to age at diagnosis
AU - Mingran Mi
AU - Meng Jin
AU - Li Meng
AU - Youzhe Gong
AU - Xuemei Zhong
PY - 2026
DA - 2026/11/03
JO - BMC Gastroenterology
DO - 10.1186/s12876-026-05485-y
UR - https://doi.org/10.1186/s12876-026-05485-y
AB - Background: This study aimed to investigate the clinical features, treatment responses, and outcomes of pediatric patients with Crohn’s disease (CD) and perianal disease (PD) in China, with a particular focus on age at diagnosis. Methods: We retrospectively analyzed 144 children diagnosed with CD between 2015 and 2024. Patients were divided into PD and non-PD groups and further stratified by age at diagnosis into very-early onset (VEO-IBD, < 6 years) and late-onset disease (LO; 6–18 years). The clinical, endoscopic, and genetic data were compared between the groups. Results: The overall prevalence of PD was 57/144 (39.58%). VEO-IBD cases accounted for 44/144 (30.56%) of cases, of whom 22/44 (50.00%) had concurrent PD; among these VEO-PD patients, the monogenic mutation rate was 17/22 (77.27%), predominantly involving IL-10RA. In the full cohort, PD was associated with increased colonic involvement (25/57 [43.86%] vs. 17/87 [19.54%], P < 0.05), greater disease severity (severe PCDAI: 25/57 [43.86%] vs. 20/87 [22.99%], P < 0.05), and lower clinical remission rates (41/57 [71.93%] vs. 83/87 [95.40%], P < 0.05). In the LO subgroup, patients with PD were treated with biologic agents significantly earlier, with clinical remission of perianal lesions reaching 30/35 (85.71%). Conclusions: VEO-IBD with PD was associated with monogenic mutations, greater disease activity, and lower clinical remission. VEO-PD had poorer outcomes than VEO-IBD without PD, although mortality was similar. In selected monogenic VEO-IBD patients, thalidomide and/or HSCT may be individualized options, but thalidomide should not be generalized to all VEO-IBD. Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12876-026-05485-y.
SN - 1471-230X
ER -