A Ricciuto et al. Journal of Crohn’s and Colitis; 2020. jjaa197, https://doi.org/10.1093/ecco-jcc/jjaa197 Link: Diagnostic Delay Is Associated with Complicated Disease and Growth Impairment in Paediatric Crohn’s Disease

Methods: “We conducted a national, prospective multi-centre IBD inception cohort study, including 1399 children. Diagnostic delay was defined as time from symptom onset to diagnosis >75 ^th percentile.”

Key findings:

• In CD, diagnostic delay was associated with a 2.5-times higher rate of strictures/internal fistulae (HR 2.53, 95% CI 1.41-4.56)
• Every additional month of diagnostic delay was associated with a decrease in height-for-age z-score of 0.13 standard deviations
• Diagnostic delay was more common in CD, particularly small bowel CD

My take: Delays in diagnosis in this study were associated with stricturing/internal fistulising complications and growth impairment in paediatric CD.  It is likely that inadequate treatment would increase the risk of these problems as well.

Related blog posts:

• “Positioning Biologic Therapies in the Management of Pediatric Inflammatory Bowel Disease” & 14% of U.S. Infected with COVID-19
• Do Biologics Alter the Natural History of Crohn’s Disease in Children?
• CCFA: Updates in IBD (2017) -Dr. Kugathasan lecture discussed the RISK study and reported that there is likely a window of opportunity to more favorably affect natural history of the disease
• Paris Classification of Pediatric Crohn’s Disease
• Delays in diagnosing Crohn’s disease (post from 2012)