Abstract
In pediatric Crohn’s disease (CD) patients, it is important to define the disease phenotype at diagnosis for stratifying risk. In this retrospective study, we aimed to assess the disease phenotype compared to EUROKIDS registry and analyze disease outcome of pediatric CD patients according to upper gastrointestinal (GI) tract involvement. A total of 312 patients were included. The median age at diagnosis was 13.7 years and 232 patients (74.4%) were identified to have upper GI involvement at diagnosis. In Korean pediatric CD patients, there were significant differences in male predominance (72.8% vs. 59.2, p < 0.001), proportion of upper GI involvement (74.4% vs. 46.2%, p < 0.001), and perianal disease (62.1% vs. 8.2%, p < 0.001) compared to data in the EUROKIDS registry. Younger age (OR 2.594, p = 0.0139) and ileal involvement (OR 2.293, p = 0.0176) at diagnosis were associated with upper GI involvement. There were no significant differences in disease outcomes between patients with and without upper GI tract involvement. This study revealed that upper GI involvement is more prevalent in Korean patients with pediatric Crohn’s disease than in European patients, and the disease outcome did not appear to differ according to upper GI tract involvement.
Highlights
Crohn’s disease (CD) is a multifactorial idiopathic chronic disease of the gastrointestinal (GI) tract with complex pathophysiology including genomes and immune responses, and variable clinical manifestations and disease course[1,2]
The secondary aim of this study was to find the factors associated with upper GI tract involvement in pediatric CD patients and differences in the disease course according to upper GI tract involvement
Patients diagnosed with ulcerative colitis, inflammatory bowel disease (IBD)-unspecified, diagnosed age at ≥ 19 years old, and those with missing baseline clinicodemographic data were excluded
Summary
Crohn’s disease (CD) is a multifactorial idiopathic chronic disease of the gastrointestinal (GI) tract with complex pathophysiology including genomes and immune responses, and variable clinical manifestations and disease course[1,2]. To select the optimal treatment and assess the prognosis of pediatric CD patients, it is important to clarify the factors influencing poor outcomes. The GETAID cohort study identified young age, upper GI tract and rectal involvement (but not colonic or ileal), and B2 and/or B3 disease behavior as prognostic factors for poor outcomes over 15 years of disease[8]. In pediatric CD patients, it is important to define the disease phenotype at diagnosis for stratifying risk and prognostic factors. The primary aim of the present study was to assess the disease phenotype of pediatric CD patients and investigate the characteristics including upper GI tract involvement. The secondary aim of this study was to find the factors associated with upper GI tract involvement in pediatric CD patients and differences in the disease course according to upper GI tract involvement
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