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      Characteristics of Pediatric Inflammatory Bowel Disease in Korea: Comparison with EUROKIDS Data

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          Abstract

          Background/Aims

          Pediatric inflammatory bowel disease (IBD) has been increasing worldwide. The characteristics of pediatric-onset IBD have mainly been reported in Western countries. We investigated the clinical characteristics of pediatric IBD in Korea and compared these with the data from the 5-year European multicenter study of children with new-onset IBD (EUROKIDS registry).

          Methods

          Children who were diagnosed with IBD between July 1987 and January 2012 were investigated at five Korean university hospitals. Their clinical characteristics were retrospectively evaluated by medical record review. The results were compared with the EUROKIDS data.

          Results

          A total of 30 children with Crohn’s disease (CD) and 33 children with ulcerative colitis (UC) were enrolled. In comparison with the EUROKIDS group, Korean pediatric IBD patients showed a male predominance (86.7% vs 59.2%, p=0.002 in CD; 75.8% vs 50%, p=0.003 in UC). Korean pediatric CD patients had a higher prevalence of terminal ileal disease (36.7% vs 16.3%, p=0.004) and perianal disease (33.3% vs 8.2%, p<0.001) than patients in the EUROKIDS group. Korean pediatric UC patients had a higher prevalence of proctitis than patients in the EUROKIDS group.

          Conclusions

          Our results suggest that the characteristics of Korean pediatric IBD patients and European pediatric IBD patients may be different.

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          Most cited references25

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          Incidence and phenotype of inflammatory bowel disease based on results from the Asia-pacific Crohn's and colitis epidemiology study.

          Siew C. Ng, Whitney Tang, Jessica Y. L. Ching … (2013)
          Inflammatory bowel diseases (IBD) are becoming more common in Asia, but epidemiologic data are lacking. The Asia-Pacific Crohn's and Colitis Epidemiology Study aimed to determine the incidence and phenotype of IBD in 8 countries across Asia and in Australia. We performed a prospective, population-based study of IBD incidence in predefined catchment areas, collecting data for 1 year, starting on April 1, 2011. New cases were ascertained from multiple overlapping sources and entered into a Web-based database. Cases were confirmed using standard criteria. Local endoscopy, pathology, and pharmacy records were searched to ensure completeness of case capture. We identified 419 new cases of IBD (232 of ulcerative colitis [UC], 166 of Crohn's disease [CD], and 21 IBD-undetermined). The crude annual overall incidence values per 100,000 individuals were 1.37 for IBD in Asia (95% confidence interval: 1.25-1.51; 0.76 for UC, 0.54 for CD, and 0.07 for IBD-undetermined) and 23.67 in Australia (95% confidence interval: 18.46-29.85; 7.33 for UC, 14.00 for CD, and 2.33 for IBD-undetermined). China had the highest incidence of IBD in Asia (3.44 per 100,000 individuals). The ratios of UC to CD were 2.0 in Asia and 0.5 in Australia. Median time from symptom onset to diagnosis was 5.5 months (interquartile range, 1.4-15 months). Complicated CD (stricturing, penetrating, or perianal disease) was more common in Asia than Australia (52% vs 24%; P = .001), and a family history of IBD was less common in Asia (3% vs 17%; P < .001). We performed a large-scale population-based study and found that although the incidence of IBD varies throughout Asia, it is still lower than in the West. IBD can be as severe or more severe in Asia than in the West. The emergence of IBD in Asia will result in the need for specific health care resources, and offers a unique opportunity to study etiologic factors in developing nations. Copyright © 2013 AGA Institute. Published by Elsevier Inc. All rights reserved.
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            The natural history of fistulizing Crohn's disease in Olmsted County, Minnesota.

            David A. Schwartz, Edward V Loftus, William J Tremaine … (2002)
            Little is known about the cumulative incidence and natural history of fistulas in Crohn's disease in the community. The medical records of all Olmsted County, Minnesota residents who were diagnosed with Crohn's disease from 1970 to 1993 and who developed a fistula were abstracted for clinical features and outcomes. Six patients denied research authorization. The cumulative incidence of fistula from time of diagnosis was estimated by using the Kaplan-Meier product-limit method. At least 1 fistula occurred in 59 patients (35%), including 33 patients (20%) who developed perianal fistulas. Twenty-six (46%) developed a fistula before or at the time of formal diagnosis. Assuming that the 9 patients with fistula before Crohn's disease diagnosis were instead simultaneous diagnoses, the cumulative risk of any fistula was 33% after 10 years and was 50% after 20 years (perianal, 21% after 10 years and 26% after 20 years). At least 1 recurrent fistula occurred in 20 patients (34%). Most fistulizing episodes (83%) required operations, most of which were minor. However, 11 perianal fistulizing episodes (23%) resulted in bowel resection. Fistulas in Crohn's disease were common in the community. In contrast to referral-based studies, only 34% of patients developed recurrent fistulas. Surgical treatment was frequently required.
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              Classification of inflammatory bowel disease.

              J E Lennard-Jones (1989)
              Infection, ischaemia, physical damage, or specific immunologic sensitivity should be excluded as far as possible before a diagnosis of non-specific inflammatory bowel disease is made. Non-specific inflammations can be subdivided on the basis of macroscopic and microscopic anatomical criteria. Macroscopic structural abnormalities can be recognized by clinical examination, endoscopy, radiology, and inspection of an operation specimen. These complementary methods of data collection combine with microscopic examinations of tissue to separate disorders that differ in prognosis and possible response to treatment. Anatomic classifications do not necessarily imply differences in aetiology and may change with advances in knowledge.
              Article 0 comments Cited 192 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Gut Liver
                Journal ID (iso-abbrev): Gut Liver
                Title: Gut and Liver
                Publisher: Editorial Office of Gut and Liver
                ISSN (Print): 1976-2283
                ISSN (Electronic): 2005-1212
                Publication date (Print): November 2015
                Publication date (Electronic): 13 May 2015
                Volume: 9
                Issue: 6
                Pages: 756-760
                Affiliations
                [* ]Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
                [† ]Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
                [‡ ]Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, Korea
                [§ ]Department of Internal Medicine, Konyang University School of Medicine, Daejeon, Korea
                [|| ]Department of Internal Medicine, St. Vincent’s Hospital, The Catholic University of Korea College of Medicine, Suwon, Korea
                Author notes
                Correspondence to: Dong Il Park, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul 03181, Korea, Tel: +82-2-2001-2059, Fax: +82-2-2001-2049, E-mail: diksmc.park@ 123456samsung.com
                Article
                Publisher ID: gnl-09-756
                DOI: 10.5009/gnl14338
                PMC ID: 4625705
                PubMed ID: 25963086
                SO-VID: 9943c638-3ab9-4fdb-b885-c1c1506b1588
                Copyright © Copyright © 2015 by The Korean Society of Gastroenterology, the Korean Society of Gastrointestinal Endoscopy, the Korean Society of Neurogastroenterology and Motility, Korean College of Helicobacter and Upper Gastrointestinal Research, Korean Association the Study of Intestinal Diseases, the Korean Association for the Study of the Liver, Korean Pancreatobiliary Association, and Korean Society of Gastrointestinal Cancer.
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 01 September 2014
                Date revision received : 14 October 2014
                Date accepted : 28 October 2014
                Categories
                Subject: Original Article

                ScienceOpen disciplines: Gastroenterology & Hepatology
                Keywords: inflammatory bowel diseases,pediatrics,characteristics,korea
                Data availability:
                ScienceOpen disciplines: Gastroenterology & Hepatology
                Keywords: inflammatory bowel diseases, pediatrics, characteristics, korea

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