Age and Family History at Presentation of Pediatric Inflammatory Bowel Disease

Weinstein, Toba; Levine, Mindy; Pettei, Michael J.; Gold, David; Kessler, Bradley; Levine, Jeremiah

doi:10.1097/00005176-200311000-00020

Cited by 68 publications

(54 citation statements)

References 28 publications

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“…Although our sample size was too small to permit definitive conclusions to be drawn, this is higher than frequencies seen in Korean adults (2.7% [14] and 1.9% [27]) and is similar to the 6.0% of children and 2.8% of adults with relevant histories reported from Japan [28]. In Western studies, the incidence of relevant family history in pediatric patients was higher (25-33%) than in our study [29,30].…”

Section: Discussionsupporting

confidence: 61%

Characteristics and Trends in the Incidence of Inflammatory Bowel Disease in Korean Children: A Single-Center Experience

et al. 2009

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Background Inflammatory bowel disease (IBD) is rare in Asian children and few reports on pediatric IBD have appeared. Aims We, therefore, investigated the incidence trends and clinical characteristics of pediatric IBD in Korea. Methods We enrolled 48 children with Crohn's disease (CD) and 14 children with ulcerative colitis (UC) from 1996 to 2007. Trends in annual enrollment and clinical characteristics were retrospectively evaluated by medical record review. Results During the 12 years of observation, the number of new enrollments gradually increased. CD showed male predominance (33 boys, 15 girls), but more females presented with UC (4 boys, 10 girls). A relevant family history was observed in 3 (4.9%) of the 61 unrelated families. The most common presenting symptom was abdominal pain (67%) in CD and hematochezia (93%) in UC. Growth delay was observed in 10% of CD patients, but not in any of the UC patients. In CD, colonic involvement occurred in 87% of patients, ileal involvement in 87%, and both the small bowel and colon were affected in 75%. With UC, pancolitis occurred in 43% of patients, left-sided colitis in 36%, and proctitis in 21%, including all three patients with appendiceal orifice inflammation. The most frequent disease behavior was inflammatory in 85% of patients, but perianal fistula was noted in 50% of CD patients. Conclusion This study showed that the incidence of pediatric IBD has been rapidly increasing in Korea in recent years. Relevant family history is less prevalent and phenotypic expression differs from what is seen in Western countries.

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Section: Discussionsupporting

confidence: 61%

Characteristics and Trends in the Incidence of Inflammatory Bowel Disease in Korean Children: A Single-Center Experience

et al. 2009

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“…(28) Hsiao et al, who looked for common mutations in the NOD2/CARD15 and TLR4 genes, which are strongly associated with CD among Caucasian patients, was unable to find any such mutations in Taiwanese children with CD. (22) This may indicate the existence of different genetic influences that are specific to the development of IBD in Asian children.…”

Section: Discussionmentioning

confidence: 99%

Paediatric inflammatory bowel disease in a multiracial Asian country

Chu

Logarajah²,

Tan³

et al. 2013

SMedJ

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Information on demographics, disease presentation, laboratory findings, radiological investigations, and endoscopic and histological findings were obtained from the patients' medical records.RESUlTS 32 patients were diagnosed with IBD, 30 of whom had Crohn's disease and 2 had ulcerative colitis. The incidence of IBD rose from an initial rate of 2.2 per 100,000 patients in the year 2000 to a peak of 11.4 patients per 100,000 patients by 2008. Median age of onset of symptoms was 10.5 years. There were more boys (63%) than girls in the group and a higher representation of Indians (34.4%). The most common presenting symptoms were abdominal pain (87.5%), diarrhoea (75.0%) and weight loss (71.9%). Extraintestinal manifestations such as fever and arthralgia were found in over 50% of patients. The most common physical findings were perianal abnormalities (56.3%), mouth ulcers (37.5%) and growth failure (15.6%). Abnormal laboratory findings such as low albumin, raised erythrocyte sedimentation rate, anaemia, thrombocytosis and high C-reactive protein were found in nearly half of the patients. Endoscopic and histological findings showed that a majority of patients (90.6%) also had evidence of inflammation in the upper gastrointestinal tract.CONClUSION Paediatric IBD is on the rise. The higher occurrence in Indians, earlier onset and more florid presentation may suggest different genetic and environmental influences specific to Asian children.

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“…Early historical studies have suggested that the phenotypic clinical expression of Crohn's disease differs substantially, depending on the age of initial diagnosis [16][17][18][19][20] . This agedependent phenotypic clinical expression probably reflects the dynamic nature of the disorder [21] .…”

Section: Age-related Phenotypic Expressionmentioning

confidence: 99%