Clinical Profile and Phenotypic Characteristics of Crohn’s Disease in Children: A Ten-Year Hospital-Based Study

Background: Crohn’s Disease (CD) is a chronic, relapsing inflammatory bowel disease characterized by transmural inflammation that may involve any part of the gastrointestinal tract. Pediatric Crohn’s disease differs from adult disease in several important respects, particularly with regard to growth, nutritional status, pubertal development, disease extent and extraintestinal manifestations. Early recognition is therefore essential to prevent long-term complications and impairment of growth and development. Objective: To describe the clinical profile, disease distribution, disease behaviour, nutritional abnormalities, laboratory findings and extraintestinal manifestations among children diagnosed with Crohn’s disease at a tertiary-care hospital over a ten-year period. Methods: This hospital-based observational study included children diagnosed with Crohn’s disease between January 2015 and December 2024. Demographic characteristics, presenting symptoms, growth parameters, disease location and behaviour, perianal manifestations, extraintestinal manifestations, laboratory abnormalities and nutritional deficiencies were evaluated. Results: A total of 23 children were evaluated, comprising 12 females and 11 males. The age at presentation ranged from 3 to 12 years. Abdominal pain was the predominant symptom and was reported in approximately 92% of children. Chronic diarrhoea, with or without blood, was present in approximately 83%. Weight loss and nutritional impairment were observed in approximately 66% of children. Growth impairment, manifested by reduced height velocity and/or downward crossing of growth percentiles, was observed in approximately 54% of children. Bone health abnormalities were identified in approximately 46%. Ileocolonic involvement was the predominant disease distribution. Most children had an inflammatory disease phenotype at presentation, while a smaller proportion had stricturing or penetrating disease. Perianal manifestations included fissures, skin tags, abscesses and fistulae. Extraintestinal manifestations included musculoskeletal, mucocutaneous, ocular and hepatobiliary involvement. Anaemia, elevated inflammatory markers, hypoalbuminemia and micronutrient deficiencies were frequent laboratory and nutritional abnormalities. Conclusion: Pediatric Crohn’s disease may present with a combination of gastrointestinal symptoms, constitutional manifestations, growth impairment, nutritional abnormalities and extraintestinal features. In children, growth failure and unexplained systemic symptoms may precede classical gastrointestinal manifestations and should prompt consideration of inflammatory bowel disease. Early recognition and multidisciplinary management are essential to optimize growth, nutrition, bone health and long-term outcomes.