Crohn's Disease in the Singapore Chinese Population

Abstract

Crohn's disease (CD) is rare in the Chinese population, but lately there seems to be an increasing trend of CD in the Singapore Chinese population. We carried out a retrospective study of all Chinese patients with CD seen from 1987 to 1993 at the Singapore General Hospital. All patients were regularly followed up and treated. Disease activity was defined by the Organisation Mondiale de Gastroenterologie index. We also compared our series with our first series reported in 1987 and a Western series. There were 32 patients (20 men, 12 women) giving a hospital prevalence of 26.7 per 100,000 patients compared with 3.5 per 100,000 patients in 1986. The mean age was 37.1 years (range, 19-80 years). Twelve patients had small intestinal disease, 9 had colonic disease, and 11 had both. The common presenting symptoms were bloody diarrhea (67%), abdominal pain (53%), loss of weight (47%), and fever (34%). Extraintestinal manifestations were rare. Six patients had no relapse during the follow-up period, whereas the remaining 26 patients had an average of two relapses (range, 1-5). These relapses were complicated by fistulas in 8 patients and strictures in 11 patients. Response to steroids and sulfasalazine was good in most patients. Four patients required repeated surgery despite medical treatment. The prevalence of CD appears to be increasing among the Singapore Chinese population. The clinical features are similar to those of the Western population. Most of our patients responded to standard medical therapy, but further follow-up is needed to assess their long-term clinical outcome.

Association analysis of genetic variants in IL23R, ATG16L1 and 5p13.1 loci with Crohn’s disease in Japanese patients

“…The combined prevalence of the two diseases in the West and in Asia has been increasing significantly over the last decade; the prevalence rate of UC and of CD in the Japanese population was estimated to be 6.31 and 0.88 per 100,000 in 1985, but the rate increased to 18.12 and 5.85 per 100,000 in 2006 (Hilmi et al 2006). A similar increasing trend in the annual incidence was observed in Korea, Singapore and China (Law et al 1998;Yang et al 2000;Leong et al 2004). Although these values in Asian countries were still relatively low when compared to Western countries (Loftus 2004), IBDs are now thought to be common diseases in Asia.…”

A hospital-based study of clinical and genetic features of Crohn’s disease

“…21 Furthermore, it has been reported to be associated with CD susceptibility in Korea and Europe. 43,44 Patients carrying the TNFSF15 (TL1A)-risk haplotype B have significantly increased expression of membrane and soluble TL1A in response to immune complexes. 45 The promoter activity of the risk allele is higher than that in the no-risk allele population in stimulated T cells.…”

Management consensus of inflammatory bowel disease for the Asia–Pacific region

“…However, Jiang and Cui reported that 70% of patients had proctitis 10 . Extra‐intestinal manifestations have been reported in 2–34% of patients with UC 9,10,16 . Disease involvement in CD is predominantly ileocolonic with approximately 30% of patients having colonic involvement and 10–20% having only small intestinal involvement.…”