Early Symptoms and Diagnostic Parameters in Pediatric Inflammatory Bowel Disease: Implications for Subsequent Bone Disorders

Background: Inflammatory bowel disease (IBD) is associated with multiple factors that influence bone metabolism. This study aimed to compare the clinical manifestations and diagnostic parameters of patients with Crohn's disease (CD) and ulcerative colitis (UC) at the time of diagnosis, as well as to assess their relationship with subsequent bone disorders. Methods: Blood tests (including calcium-phosphate metabolism) and fecal tests (including calprotectin) were performed in eighty children recently diagnosed with IBD. Additionally, the bone densitometry results were evaluated in 25 of them. Results: Diarrhea (p=0.02) and bloody stools (p<0.001) were more frequent in patients with UC, whereas fever was more common in patients with CD (p=0.003). Laboratory tests revealed anemia in 57.5% (46/80) and thrombocytosis in 36.3% (29/80). Higher calprotectin levels in the feces were found in girls at the time of diagnosis (p = 0.02). Osteopenia was detected in almost half of the patients, and 1/5 met the criteria for osteoporosis. Low calcium levels at diagnosis were correlated with subsequent bone disorders (p = 0.005). Insufficient level of vitamin D were detected in 77.8% (56/80). Conclusions: Early disease detection and appropriate monitoring of pediatric IBD patients may decrease the risk of serious consequences, including osteoporosis.