Early onset of inflammatory bowel disease

Introduction. The incidence of inflammatory bowel disease (IBD), as well as the cases of early presentation, are increasing. For this reason, we present a case of IBD which onset occurred during the first year of life. Clinical observation. A 15 mo child presented with a 5-month history of hematochezia and failure to thrive. Initial evaluations included studies for infectious etiologies and food allergies. The patient had anemia and inflammatory signs. Upper and lower endoscopies, with multiple biopsies were performed. Pathology showed the presence of a lymphoplasmocytic infiltrate consistent with colitis. Treatment with steroids was started, with rapid clinical improvement and normalization of the laboratory parameters. The patient was then started on maintenance with mesalazine, with normalization of the weight and height. Comments. IBD has a nonspecific presentation in early childhood. Thus, in cases of gastrointestinal problems of torpid evolution in which other common etiologies have been ruled out, IBD must be considered. Lack of early diagnosis may result in worsening morbidity, such in the case under discussion, where the failure to thrive was not corrected until appropriate treatment was administered.