Center for Pediatric Inflammatory Bowel Disease

Clinical Studies: Disease Demographics

Crohn's disease (CD) and ulcerative colitis (UC) in a pediatric population: characteristics, ethnicity and relative frequency

W.C. Jeshion, R.N. Baldassano, P.D. Han, D.A. Piccoli

Background

There is little data about the demographics of inflammatory bowel disease (IBD) in modern American pediatric patients (pts.). The aim of this study is to evaluate the characteristics and ethnic backgrounds of a pediatric IBD population.

Methods

Families of pts. Seen at CHOP were sent questionnaires on diagnosis, gender, family history of IBD and ethnic background of the pts' grandparents.

Results

337 pts. responded and were classified as CD, indeterminate colitis (IC) or UC. Pts. were assigned to a certain "ethnic heritage" if at least 12.5% of their background was from that group and to a certain "ethnic group" if it accounted for > =50% of their background.

Ethnicity >=50% one ethnic group CD:UC ratio "Heritage"
Jewish n=57 65% CD, 30% UC 2.2:1 n=64
Italian n=55 60% CD, 29% UC 2.1:1 n=97
German n=49 51% CD, 43% UC 1.2:1 n=106
Irish n=55 51% CD, 43% UC 1.4:1 n=130
British Isles n=31 48% CD, 45% UC 1.1:1 n=86
Black n=15 60% CD, 20% UC 3.0:1 n=15

Of 337 respondents, 192 (57%) had CD, 24 (7%) IC, and 121 (36%) UC. The male:female ratio was 1.3:1 (1.7:1 for CD, 0.8:1 for UC). 92.9% were white, 4.4% black, 1.2% Hispanic and 1.5% other. 55 pts. (16%) were diagnosed with IBD before the age of 6 years (20CD, 11 IC, 24 UC). 290 pts. (86%) have at least 50% of one ethnic background (n=248 for one ethnic group only; 42 fall equally into two groups). The immediate family history (siblings, parents and grandparents only) was positive for IBD in 45 (23%) pts. with CD and 31 (26%) pts. with UC.

Conclusions

In this pediatric population, CD is more common that UC in all ethnic groups, but to highly varying degrees (mean 1.6:1, range 3.0:1 tot 1.1:1). IBD in pediatrics is widely distributed among ethnic groups, most commonly Jewish (n=57), Italian (n=55). German (n=49) and Irish (n=48). A family history of IBD and early onset IBD may be more common than reported. Studies of the relationship between ethnic groups and IBD are complicated by the large number of pts. with multiple ethnic (and genetic) backgrounds. AGA Abstracts. Gastroenterology. 1998.

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