{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,31]],"date-time":"2026-01-31T05:58:35Z","timestamp":1769839115450,"version":"3.49.0"},"reference-count":38,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T00:00:00Z","timestamp":1761091200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/501100000265","name":"Medical Research Council","doi-asserted-by":"publisher","award":["G0800675"],"award-info":[{"award-number":["G0800675"]}],"id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Edinburgh Children\u2019s Hospital Charity"},{"DOI":"10.13039\/100030827","name":"NHS","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100030827","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Research Scotland Career Researcher Fellowships"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,2,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Very early-onset inflammatory bowel disease (VEOIBD) (diagnosed under 6 years of age) has attracted considerable attention in recent years, with monogenic forms providing insight into immune dysregulation. However, the majority of VEOIBD patients have a classical polygenic phenotype and a similar disease course to older children.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The study sought to assess the incidence trends of VEOIBD in Scotland from 1981 to 2014 and to describe the natural history, phenotype, and treatment burden of VEOIBD in a regional cohort from South-East Scotland (1997-2021).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Nationally, 128 (8.1%) of 1567 incident pediatric inflammatory bowel disease (IBD) patients (&amp;lt;16\u2009years of age at diagnosis) were VEOIBD; 10 (8%) of 128 were diagnosed &amp;lt;2\u2009years of age. The incidence of VEOIBD rose from 0.64 per 100\u2009000 per year (1981-1985) to 2.73 per 100\u2009000 per year (2011-2014) (P\u2009=\u2009.002), an incidence rate ratio of 4.3 (95% confidence interval, 2.4-8.3). The average annual percentage change was 3.9% (95% confidence interval, 2.1%-5.7%) (P\u2009&amp;lt;\u2009.05). Crohn\u2019s disease was the most common subtype (63%); the median age at diagnosis was 4.4\u2009years. The regional cohort (n\u2009=\u200946) had a median follow-up of 11.9\u2009years. Crohn\u2019s disease cases presented with isolated colonic involvement in 47%, with pancolitis present in 64% of ulcerative colitis cases. Treatment exposures included immunosuppression (76%), corticosteroids (67%), and anti-tumor necrosis factor therapies (50%). A total of 11% were on no IBD-specific therapy at last follow-up, 11% required surgery and no patient had a diagnosis of monogenic IBD, cancer, or death.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Scotland has a high incidence of VEOIBD, with monogenic IBD exceptionally rare. Although VEOIBD disease burden is high, treatment outcomes are broadly similar to those diagnosed later in childhood based on previous studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ibd\/izaf229","type":"journal-article","created":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T12:03:55Z","timestamp":1757592235000},"page":"261-270","source":"Crossref","is-referenced-by-count":0,"title":["Incidence and Natural History of Very Early-Onset Inflammatory Bowel Disease in Scotland: National and Regional Cohort Studies"],"prefix":"10.1093","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3634-6428","authenticated-orcid":false,"given":"Paul","family":"Henderson","sequence":"first","affiliation":[{"name":"Child Life and Health, University of Edinburgh , Edinburgh,","place":["United Kingdom"]},{"name":"Department of Paediatric Gastroenterology and Nutrition, Royal Hospital for Children and Young People , Edinburgh,","place":["United 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