Pediatric-Onset Crohn’s Disease in Hispanics: A Comparison With an Adult-Onset Cohort

Background: Pediatric inflammatory bowel disease (IBD), defined as diagnosis before the age of 19, has garnered increasing attention due to its potential implications for disease outcomes. Evidence suggests that the age of disease manifestation might influence disease progression. There are very few reports of pediatric-onset IBD in Hispanics. This study aims to characterize pediatric onset of Crohn’s disease (CD) in a cohort of Hispanics and compare it to adult-onset CD subjects. Methods: The UPR Registry of IBD is an ongoing database actively recruiting participants since 1995. A cohort of 322 patients with confirmed CD recruited between 2002 and 2022 was analyzed. Subjects were categorized into pediatric (≤18 years) and adult diagnosis (> 19 years) cohorts. Univariate analysis was employed for population description. Categorical variables were compared via Chi2 test, while continuous variables were compared using Wilcoxon rank-sum test. Statistical significance was set at p < 0.05. The study is approved by the MSC-IRB. Results: 322 CD patients, 126 with pediatric diagnosis and 196 with adult diagnosis were included. Gender distribution, phenotype, location, hospitalizations, and surgery exhibited no significant differences (p = 0.164, p = 0.365, p = 0.780, p = 0.490, p = 0.741, respectively). Family history of IBD showed a trend towards significance (p = 0.074). Pediatric patients experienced a shorter delay in diagnosis (1.2 years) compared to adults (3.7 years). The presence of extraintestinal manifestations (EIMs) showed a significant association with age at diagnosis (p = 0.012), with pediatric subjects exhibiting a higher prevalence of EIMs (22.2%) compared to adults (11.7%). Perianal disease was significantly higher (p = 0.039), in pediatric subjects (38.8%) than in adults (26.5%). Conclusions: This study of a Hispanic cohort of patients with IBD reveals some significant associations in disease characteristics linked to a diagnosis of CD in childhood. The higher prevalence of EIMs and perianal disease, and a shorter diagnostic delay in the pediatric group represent important differences from adults. More studies are needed to explore the role of childhood onset in this disease and to guide management of this vulnerable population.