|
KMID : 1038820200230010049
|
|
Pediatric Gastroenterology, Hepatology & Nutrition
2020 Volume.23 No. 1 p.49 ~ p.62
|
|
|
Korean Children and Adolescents with Crohn's Disease Are More Likely to Present with Perianal Fistulizing Disease at Diagnosis Compared to Their European Counterparts
|
|
Kang Ben
Kim Jung-Eun
Jung Jae-Hun
Choe Jae-Young
Kim Mi-Jin
Choe Yon-Ho
Kim Seung
Koh Hong
Lee Yoo-Min
Lee Jee-Hyun
Lee Yoon
Lee Ji-Hyuk
Lee Hae-Jeong
Jang Hyo-Jeong
Choi You-Jin
Choi So-Yoon
Kim Ju-Young
Choe Byung-Ho
|
|
|
Abstract
|
|
|
Purpose: We aimed to investigate the disease phenotype of Korean pediatric Crohn's disease (CD) patients at diagnosis according to the Paris classification by comparison with patients from the European multicenter 5-years recruitment of children with newly developed IBD (EUROKIDS registry).
Methods: Korean children and adolescents who had been newly diagnosed with CD at the age of <18 years during 2013?2016 were included in this multicenter retrospective study. Disease phenotype at diagnosis was classified according to the Paris classification, and compared with the published data from the EUROKIDS study.
Results: A total of 255 patients were included. The median diagnosis age was 14.7 years (range, 0.8?17.9 years). No significant difference was observed in male-to-female ratio with EUROKIDS (1.9:1 vs. 1.45:1, p=0.062). The proportion of children aged <10 years was significantly lower in Koreans (7.1% vs. 19.6%, p<0.001). Colonic disease was less prominent (10.0% vs. 27.3%, p<0.001), while upper GI involvement was more prominent in Korean children (59.3% vs. 46.2%, p<0.001). The proportion with perianal fistulizing disease at diagnosis was significantly higher in Korean patients (44.8% vs. 8.2%, p<0.001). A separate analysis of Korean patients revealed that perianal fistulizing disease at diagnosis was positively associated with male sex and body mass index z-score (odds ratio [OR]=2.12, 95% confidence interval [CI]=1.20?3.76, p=0.010; and OR=1.29, 95% CI=1.05?1.58, p=0.015, respectively).
Conclusion: Approximately half of pediatric CD patients in Korea present with perianal fistulas and/or abscesses at diagnosis, which is a distinct feature of CD in Korean children and adolescents compared to their European counterparts. An underlying genetic difference between ethnicities may play a role in this expression of different phenotypes in pediatric CD.
|
|
|
KEYWORD
|
|
|
Crohn disease, Fistula, Abscess, Paris, Classification, Phenotype, Korea, Europe, Pediatrics, Inflammatory bowel disease
|
|
|
FullTexts / Linksout information
|
|
|
|
|
Listed journal information
|
|
 
|
|