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Inflammatory bowel disease characteristics in Hispanic children in Texas
Lana N Hattar1, Bincy P Abraham, Hoda M Malaty
1Department of Pediatrics, Baylor College of Medicine, Houston, TX77030, USA.
Insights
Pediatric inflammatory bowel disease (IBD) shows distinct patterns in Hispanic children, who present with more ulcerative colitis and IBD-unclassified, and receive different initial treatments compared to other ethnicities.
Area of Science:
- Pediatric gastroenterology
- Inflammatory bowel disease epidemiology
- Ethnic variations in disease presentation
Background:
- Inflammatory bowel disease (IBD) exhibits diverse clinical presentations across ethnic groups.
- The pediatric Hispanic population with IBD remains understudied, necessitating further investigation.
Purpose of the Study:
- To evaluate and compare the demographic and clinical characteristics of pediatric IBD patients of Hispanic ethnicity against other ethnic groups.
- To analyze differences in initial therapeutic approaches among these diverse pediatric IBD populations.
Main Methods:
- Retrospective analysis of pediatric patients (<18 years) diagnosed with IBD between 2004-2009 at Texas Children's Hospital.
- Comparison of Hispanic patients with White, African American, and other ethnic groups based on demographics, disease type, and initial treatment.
Main Results:
- Hispanic children showed a higher proportion of ulcerative colitis (UC) and IBD-unclassified (IBD-U) compared to Crohn's disease (CD).
- Hispanics had higher Medicaid coverage, no family history of IBD, younger age at diagnosis, and higher BMI Z-scores.
- Treatment disparities were observed, with Hispanics receiving more systemic steroids for CD and local steroids/5-ASA for UC/IBD-U, and less immunomodulators or biologics.
Conclusions:
- Significant differences in IBD characteristics and initial treatment exist between pediatric Hispanic and non-Hispanic populations.
- Further epidemiological research with long-term follow-up is crucial to fully understand the burden of IBD in Hispanic children.
Background:
Inflammatory bowel disease (IBD) has a wide spectrum and variability among different ethnic groups. We aimed to evaluate disease characteristics in the pediatric Hispanic population, which has not been well studied.
Methods:
We identified patients <18 years old seen at Texas Children's Hospital (TCH) and diagnosed with IBD between 2004 and 2009. We compared them with their White, African American, and "other" counterparts with regard to their demographics, disease characteristics, and initial therapy.
Results:
There were a total of 399 patients with IBD: 211 (52.9%) White, 67 (16.8%) African American, 53 (13.3%) Hispanic, and 68 (17%) "other." Crohn's disease (CD) was the most common IBD type among all groups; however, Hispanics had the highest proportion of patients with ulcerative colitis (UC) and IBD-unclassified (IBD-U). There was male predominance in all groups except African Americans. Hispanics had the highest percentage of Medicaid coverage (P < 0.01) and none of the Hispanics had a first-degree relative with IBD. They had a younger age at diagnosis but a similar duration of symptoms prior to diagnosis. Hispanics had less failure to thrive and a higher body mass index (BMI) Z-score. Hispanics with CD more often received systemic steroids while those with UC and IBD-U were more often treated with local steroids (P < 0.01), oral 5-aminosalicylate (P < 0.01), and less often received immunomodulators or biologics (P = 0.05).
Conclusions:
We demonstrate differences in disease characteristics between Hispanics and other ethnicities with IBD. Further epidemiologic studies are needed, including longer-term follow-up, to better define the burden of illness in Hispanics.
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