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Perianal Crohn Disease in a Large Multicenter Pediatric Collaborative
Jeremy Adler1, Shiming Dong, Sally J Eder
1*Division of Pediatric Gastroenterology †Child Health Evaluation and Research (CHEAR) Unit, University of Michigan, Ann Arbor, MI ‡ImproveCareNow, Inc., Burlington, VT.
Journal of Pediatric Gastroenterology and Nutrition
|November 2, 2016
Summary
Perianal disease affects 21% of pediatric Crohn disease (CD) patients, being more common in boys and Black children. Early intervention strategies are needed to prevent its development in children with CD.
Area of Science:
- Pediatric Gastroenterology
- Inflammatory Bowel Disease Epidemiology
Background:
- Perianal complications of Crohn disease (CD) are frequent but poorly understood in pediatric populations.
- Limited data exists on the epidemiology of perianal CD in children.
Purpose of the Study:
- To characterize the prevalence of perianal disease in a large, diverse cohort of pediatric patients with CD.
- To identify demographic and clinical factors associated with perianal disease development in pediatric CD.
Main Methods:
- Retrospective analysis of a prospective observational cohort (ImproveCareNow Network, 2006-2014).
- Inclusion of 6679 pediatric CD patients with prospective data on physical examinations and phenotype.
- Stratification by age, sex, and race; logistic regression and Kaplan-Meier analyses used.
Main Results:
- 21% (1399/6679) of pediatric CD patients developed perianal disease.
- Perianal disease was more common in boys (22%) vs. girls (20%) and in Black (26%) vs. White (20%) children.
- Disease onset was earlier in patients with later-onset CD and in Asian patients with later-onset CD.
Conclusions:
- Perianal disease is more prevalent in pediatric CD than previously recognized.
- Significant differences in perianal disease development exist across racial and sex subgroups.
- Novel treatment strategies are required to prevent perianal disease in pediatric CD patients.
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