Phenotypic characteristics of pediatric inflammatory bowel disease in Japan: results from a multicenter registry
Katsuhiro Arai1, Reiko Kunisaki2, Fumihiko Kakuta3
1Division of Gastroenterology, National Center for Child Health and Development, Setagaya, Japan.
Insights
Japanese children with inflammatory bowel disease (IBD) show distinct characteristics compared to European counterparts. Upper gastrointestinal and perianal Crohn's disease (CD) are more prevalent in Japanese pediatric IBD patients.
Area of Science:
- Pediatric Gastroenterology
- Inflammatory Bowel Disease Research
- Comparative Clinical Studies
Background:
- Limited registry data exists for pediatric inflammatory bowel disease (IBD) in Asia.
- Registry networks are crucial for inter-ethnic comparisons of IBD characteristics.
- Understanding ethnic variations in pediatric IBD is essential for tailored management.
Purpose of the Study:
- To investigate the epidemiological and clinical features of IBD in Japanese children.
- To compare the characteristics of pediatric IBD in Japan with those reported in European populations.
- To identify potential ethnic-specific patterns in pediatric IBD presentation.
Main Methods:
- A cross-sectional, multicenter registry study involving newly diagnosed Japanese pediatric IBD patients.
- Utilized the Paris classification system for categorizing IBD features.
- Compared findings with published data from the EUROKIDS registry.
Main Results:
- Analysis included 91 Crohn's disease (CD), 146 ulcerative colitis (UC), and 6 IBD-unclassified cases.
- Japanese pediatric CD patients exhibited significantly more upper gastrointestinal involvement (L4a) and ileocolonic disease (L3).
- Perianal CD was notably more prevalent in Japanese children (34.1%) compared to European children (9.7%).
Conclusions:
- Upper gastrointestinal and perianal lesions are more frequent in Japanese pediatric CD patients.
- Significant differences in disease location and behavior exist between Japanese and European pediatric IBD populations.
- Highlights the need for culturally sensitive approaches in pediatric IBD care.
Background/Aims:
There are few published registry studies from Asia on pediatric inflammatory bowel disease (IBD). Registry network data enable comparisons among ethnic groups. This study examined the characteristics of IBD in Japanese children and compared them with those in European children.
Methods:
This was a cross-sectional multicenter registry study of newly diagnosed Japanese pediatric IBD patients. The Paris classification was used to categorize IBD features, and results were compared with published EUROKIDS data.
Results:
A total of 265 pediatric IBD patients were initially registered, with 22 later excluded for having incomplete demographic data. For the analysis, 91 Crohn's disease (CD), 146 ulcerative colitis (UC), and 6 IBD-unclassified cases were eligible. For age at diagnosis, 20.9% of CD, 21.9% of UC, and 83.3% of IBD-unclassified cases were diagnosed before age 10 years. For CD location, 18.7%, 13.2%, 64.8%, 47.3%, and 20.9% were classified as involving L1 (ileocecum), L2 (colon), L3 (ileocolon), L4a (esophagus/stomach/duodenum), and L4b (jejunum/proximal ileum), respectively. For UC extent, 76% were classified as E4 (pancolitis). For CD behavior, B1 (non-stricturing/non-penetrating), B2 (stricturing), B3 (penetrating), and B2B3 were seen in 83.5%, 11.0%, 3.3%, and 2.2%, respectively. A comparison between Japanese and European children showed less L2 involvement (13.2% vs. 27.3%, P< 0.01) but more L4a (47.3% vs. 29.6%, P< 0.01) and L3 (64.8% vs. 52.7%, P< 0.05) involvement in Japanese CD children. Pediatric perianal CD was more prevalent in Japanese children (34.1% vs. 9.7%, P< 0.01).
Conclusions:
Upper gastrointestinal and perianal CD lesions are more common in Japanese children than in European children.
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