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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

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Author(s)
Ben KangJung Eun KimJae Hun JungJae Young ChoeMi Jin KimYon Ho ChoeSeung KimHong KohYoo Min LeeJee Hyun LeeYoon LeeJi-Hyuk LeeHae Jeong LeeHyo-Jeong JangYoujin ChoiSo Yoon ChoiJu Young KimByung-Ho Choe
Keimyung Author(s)
Jang, Hyo Jeong
Department
Dept. of Pediatrics (소아청소년학)
Journal Title
Pediatric Gastroenterology, Hepatology & Nutrition
Issued Date
2020
Volume
23
Issue
1
Keyword
Crohn diseaseFistulaAbscessParisClassificationPhenotypeKoreaEuropePediatricsInflammatory bowel disease
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.
Keimyung Author(s)(Kor)
장효정
Publisher
School of Medicine (의과대학)
Citation
Ben Kang et al. (2020). Korean Children and Adolescents with Crohn’s Disease Are More Likely to Present with Perianal Fistulizing Disease at Diagnosis Compared to Their European Counterparts. Pediatric Gastroenterology, Hepatology & Nutrition, 23(1), 49–62. doi: 10.5223/pghn.2020.23.1.49
Type
Article
ISSN
2234-8840
Source
https://www.pghn.org/DOIx.php?id=10.5223/pghn.2020.23.1.49
DOI
10.5223/pghn.2020.23.1.49
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/42741
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Pediatrics (소아청소년학)
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