Current issues of pediatric inflammatory bowel disease in Korea

Abstract

Inflammatory bowel disease (IBD) is a chronic relapsing disorder of unknown etiology, which is believed to be multifactorial. Recently, the incidence of pediatric IBD has steeply increased in Korea since 2000. Poorly controlled disease activity can result in complications such as intestinal fistulae, abscess, and stricture, as well as growth retardation and delayed puberty in children. Because of a lack of confirmative tests, various diagnostic modalities must be used to diagnose IBD. Onset age, location, behavior, and activity are important in selecting treatments. Monogenic IBD must be excluded among infantile and refractory very-early-onset IBD. Early aggressive therapy using biologics has recently been proposed for peripubertal children to prevent growth failure and malnutrition.

Renal involvement in children and adolescents with inflammatory bowel disease

“…However, the incidence of IBD has shown a rapid rise after the 1990s. Recently, the incidence of pediatric IBD has shown a steep rise in Korea since 2000 [ 1 ]. Pediatric IBD usually demonstrates a more severe presentation of IBD than that in adults with widespread infiltration and more common colonic lesions.…”

“…PCDAI scores range from 0–100, and this index classifies disease activity as no disease activity (<10), mild disease activity (11–30), and moderate-to-severe disease activity (≥30). PUCAI scores range from 0–85 and this index classifies disease activity as no disease activity (<10), mild disease activity (11–34), moderate disease activity (35–64), and severe disease activity (≥65) [ 1 , 8 ]. The Institutional Review Board at Kyungpook National University Hospital, Daegu, South Korea reviewed and approved this study (approval number: KNUMC_2017-10-007).…”

“…Inflammatory bowel disease (IBD) is a chronic inflammation of the gastrointestinal tract that presents with recurring bouts of inflammation and remission. The 2 most common types of IBD are Crohn disease (CD) and ulcerative colitis (UC) [ 1 , 2 ]. Pediatric IBD, which was previously rare in Koreans, has shown a rapid rise in incidence after the 1990s, with a pronounced increase over the last 5 years.…”

“…Pediatric IBD, which was previously rare in Koreans, has shown a rapid rise in incidence after the 1990s, with a pronounced increase over the last 5 years. The age of onset of IBD is 15–25 years, and CD is more common in children than in adults [ 1 ]. Extraintestinal manifestations are varied from 25% to 40% in both adults and children with IBD, but kidney and lower genitourinary involvement has been reported in 4%–23% of adult patients with IBD and 1%–2% of children with IBD [ 2 ].…”

Nutritional aspect of pediatric inflammatory bowel disease: its clinical importance

“…Incidence of the disease is rapidly increasing worldwide and up to 25% of patients are diagnosed during their childhood or adolescence 1) . Although the exact incidence of IBD is not well known, it is also believed to be rapidly increasing in Korean children 2) . Only 4 patients were diagnosed with IBD from 1996-2001 in a single center study in Korea, while 58 patients were diagnosed with IBD from 2002-2007 3) .…”