Genetic Variants in Early-Onset Inflammatory Bowel Disease: Monogenic Causes and Clinical Implications

<b>Background/Objectives:</b> This study aims to identify genetic variants associated with early-onset inflammatory bowel disease (IBD) and to improve diagnostic and therapeutic approaches. In selected monogenic IBD cases, treatment included colchicine, interleukin-1 inhibitors, and hema...

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Main Authors: Duygu Demirtas Guner, Hacer Neslihan Bildik, Hulya Demir, Deniz Cagdas, Inci Nur Saltik Temizel, Riza Koksal Ozgul, Hayriye Hizarcioglu Gulsen, Cagman Tan, Begum Cicek, Hasan Ozen, Aysel Yuce, Ilhan Tezcan
Format: Article
Language:English
Published: MDPI AG 2025-04-01
Series:Children
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Online Access:https://www.mdpi.com/2227-9067/12/5/536
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Summary:<b>Background/Objectives:</b> This study aims to identify genetic variants associated with early-onset inflammatory bowel disease (IBD) and to improve diagnostic and therapeutic approaches. In selected monogenic IBD cases, treatment included colchicine, interleukin-1 inhibitors, and hematopoietic stem cell transplantation. <b>Methods:</b> This study included patients with early-onset IBD, defined as IBD diagnosed before the age of 10, who were under follow-up at the Department of Pediatric Gastroenterology, Hacettepe University, and agreed to participate between December 2018 and April 2021. Whole-exome sequencing (WES) was performed prospectively in patients without a prior diagnosis of monogenic disease, while clinical and laboratory data were reviewed retrospectively. Identified variants were evaluated for pathogenicity using standard bioinformatics tools. <b>Results:</b> A total of 47 patients were enrolled, including 33 boys (70.2%) and 14 girls (29.8%). The median age at symptom onset was 36 months (IQR: 10–72), and the median age at diagnosis was 3.7 years (IQR: 1.5–7.6). Crohn’s disease was diagnosed in 53.2% (<i>n</i> = 25), ulcerative colitis in 38.3% (<i>n</i> = 18), and unclassified IBD in 8.5% (<i>n</i> = 4). Monogenic IBD was identified in 36.2% (<i>n</i> = 17) of patients, including nine with Familial Mediterranean Fever and others with glycogen storage disease type 1b (<i>n</i> = 2), XIAP deficiency, chronic granulomatous disease, DOCK8 deficiency, IL10 receptor alpha defect, LRBA deficiency, and NFKB2 deficiency (<i>n</i> = 1 each). A novel SLC29A3 gene variant (c.480_481delTGinsCA, p.V161I) (transcript ID: ENST00000479577.2) was identified in 76.6% (<i>n</i> = 36) of patients. <b>Conclusions:</b> This study underscores the importance of genetic variants in early-onset IBD, particularly MEFV and the novel NFKB2. The frequent detection of the SLC29A3 variant may suggest its potential involvement in the pathogenesis of the disease.
ISSN:2227-9067