Pediatric Gastroenterology, Hepatology & Nutrition

The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition (대한소아소화기영양학회)
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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 (Department of Pediatrics, School of Medicine, Kyungpook National University) ;
  • Kim, Jung Eun (Department of Pediatrics, School of Medicine, Kyungpook National University) ;
  • Jung, Jae Hun (Department of Pediatrics, School of Medicine, Kyungpook National University) ;
  • Choe, Jae Young (Department of Emergency Medicine, School of Medicine, Kyungpook National University) ;
  • Kim, Mi Jin (Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Choe, Yon Ho (Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Kim, Seung (Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine) ;
  • Koh, Hong (Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine) ;
  • Lee, Yoo Min (Department of Pediatrics, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine) ;
  • Lee, Jee Hyun (Department of Pediatrics, Korea University Ansan Hospital, Korea University College of Medicine) ;
  • Lee, Yoon (Department of Pediatrics, Korea University Anam Hospital, Korea University College of Medicine) ;
  • Lee, Ji-Hyuk (Department of Pediatrics, Chungbuk National University College of Medicine) ;
  • Lee, Hae Jeong (Department of Pediatrics, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine) ;
  • Jang, Hyo-Jeong (Crohn's and Colitis Association in Daegu-Gyeongbuk (CCAiD)) ;
  • Choi, Youjin (Department of Pediatrics, Inje University Ilsan Paik Hospital, Inje University College of Medicine) ;
  • Choi, So Yoon (Department of Pediatrics, Inje University Haeundae Paik Hospital, Inje University College of Medicine) ;
  • Kim, Ju Young (Department of Pediatrics, Eulji University School of Medicine) ;
  • Choe, Byung-Ho (Department of Pediatrics, School of Medicine, Kyungpook National University)
  • Received : 2019.12.19
  • Accepted : 2019.12.26
  • Published : 2020.01.15
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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.

Keywords

References

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