Hyun Jin Kim1, Seak Hee Oh2, Dae Yeon Kim3, Ho-Su Lee4, Sang Hyoung Park5, Suk-Kyun Yang5, Kyung Mo Kim6. 1. Department of Pediatrics, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea. 2. Department of Pediatrics and. 3. Pediatric Surgery, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, Seoul, Korea. 4. Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. 5. Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. 6. Department of Pediatrics and kmkim@amc.seoul.kr.
Abstract
BACKGROUND AND AIMS: Although paediatric Crohn's disease [CD] has a different phenotype and clinical course to adult CD, its clinical features and surgical risks are poorly defined, especially in Asian countries. The aim of this study was to investigate the clinical features and long-term outcomes of paediatric CD in a Korean population. METHODS: We retrospectively analysed 594 patients who were younger than 18 years of age at CD diagnosis between 1987 and 2013. Patient characteristics at diagnosis according to the Paris classification and clinical courses were analysed. RESULTS: The male-to-female ratio was 2.4:1 and the median age at CD diagnosis was 15 years [range, 2-17 years]. A positive first-degree family history of inflammatory bowel disease was present in 30 patients [5.1%]. Sixty-seven patients [11.3%] showed growth impairment. The cumulative probabilities of perianal fistula at 1, 5 and 10 years after diagnosis were 50.3%, 54.9% and 57.6%, respectively. The cumulative probabilities of anti-tumour necrosis factor treatment at 1, 5, 10 and 20 years after diagnosis were 10.7%, 25.8%, 41.8% and 76.3%, respectively. The cumulative probabilities of intestinal resection at 1, 5, 10 and 20 years after diagnosis were 4.5%, 17.2%, 33.9% and 62.9 %, respectively. In multivariate analysis, complicated behaviour and isolated colonic location [L2] at diagnosis were associated with an increased and decreased risk of intestinal resection, respectively. CONCLUSIONS: Our study is the largest Asian paediatric study which applied the Paris classification to patients. This study provides detailed information on disease phenotype and long-term clinical outcomes in a large cohort of Asian children with CD.
BACKGROUND AND AIMS: Although paediatric Crohn's disease [CD] has a different phenotype and clinical course to adult CD, its clinical features and surgical risks are poorly defined, especially in Asian countries. The aim of this study was to investigate the clinical features and long-term outcomes of paediatric CD in a Korean population. METHODS: We retrospectively analysed 594 patients who were younger than 18 years of age at CD diagnosis between 1987 and 2013. Patient characteristics at diagnosis according to the Paris classification and clinical courses were analysed. RESULTS: The male-to-female ratio was 2.4:1 and the median age at CD diagnosis was 15 years [range, 2-17 years]. A positive first-degree family history of inflammatory bowel disease was present in 30 patients [5.1%]. Sixty-seven patients [11.3%] showed growth impairment. The cumulative probabilities of perianal fistula at 1, 5 and 10 years after diagnosis were 50.3%, 54.9% and 57.6%, respectively. The cumulative probabilities of anti-tumour necrosis factor treatment at 1, 5, 10 and 20 years after diagnosis were 10.7%, 25.8%, 41.8% and 76.3%, respectively. The cumulative probabilities of intestinal resection at 1, 5, 10 and 20 years after diagnosis were 4.5%, 17.2%, 33.9% and 62.9 %, respectively. In multivariate analysis, complicated behaviour and isolated colonic location [L2] at diagnosis were associated with an increased and decreased risk of intestinal resection, respectively. CONCLUSIONS: Our study is the largest Asian paediatric study which applied the Paris classification to patients. This study provides detailed information on disease phenotype and long-term clinical outcomes in a large cohort of Asian children with CD.
Authors: Sung Bae Kim; Jae Hee Cheon; Jae Jun Park; Eun Soo Kim; Seong Woo Jeon; Sung-Ae Jung; Dong Il Park; Chang Kyun Lee; Jong Pil Im; You Sun Kim; Hyun Soo Kim; Jun Lee; Chang Soo Eun; Jeong Mi Lee; Byung Ik Jang; Geom Seog Seo Journal: Gut Liver Date: 2020-05-15 Impact factor: 4.519
Authors: Ben Kang; Jung Eun Kim; Jae Hun Jung; Jae Young Choe; Mi Jin Kim; Yon Ho Choe; Seung Kim; Hong Koh; Yoo Min Lee; Jee Hyun Lee; Yoon Lee; Ji-Hyuk Lee; Hae Jeong Lee; Hyo-Jeong Jang; Youjin Choi; So Yoon Choi; Ju Young Kim; Byung-Ho Choe Journal: Pediatr Gastroenterol Hepatol Nutr Date: 2020-01-09