Korean Children and Adolescents with Crohn's Disease Are More Likely to Present with Perianal Fistulizing Disease at Diagnosis Compared to Their European Counterparts
- Authors
- 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, Youjin; Choi, So Yoon; Kim, Ju Young; Choe, Byung-Ho
- Issue Date
- Jan-2020
- Publisher
- 대한소아소화기영양학회
- Keywords
- Crohn disease; Fistula; Abscess; Paris; Classification; Phenotype; Korea; Europe; Pediatrics; Inflammatory bowel disease
- Citation
- Pediatric Gastroenterology, Hepatology & Nutrition, v.23, no.1, pp 49 - 62
- Pages
- 14
- Journal Title
- Pediatric Gastroenterology, Hepatology & Nutrition
- Volume
- 23
- Number
- 1
- Start Page
- 49
- End Page
- 62
- URI
- https://scholarworks.bwise.kr/sch/handle/2021.sw.sch/3252
- DOI
- 10.5223/pghn.2020.23.1.49
- ISSN
- 2234-8646
2234-8840
- 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.
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Collections - College of Medicine > Department of Pediatrics > 1. Journal Articles
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