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Disease Presentation and Clinical Course in Black and White Children With Inflammatory Bowel Disease

2007; Lippincott Williams & Wilkins; Volume: 44; Issue: 5 Linguagem: Inglês

10.1097/mpg.0b013e3180335bb3

1536-4801

Alexandra Eidelwein, Richard H. Thompson, Kristin Fiorino, Vivian Abadom, Maria Oliva‐Hemker,

Immunodeficiency and Autoimmune Disorders

ABSTRACT Objectives: To compare the disease presentation, disease phenotype, and clinical course between black and white children with inflammatory bowel disease (IBD). Patients and Methods: A 10‐year retrospective review was undertaken of the medical records of 245 pediatric patients with IBD studied at a tertiary care center. Results: In this patient population 24% were black and 76% were white. There were no differences between black and white patients in terms of anatomic distribution of IBD, symptom presentation, and extraintestinal manifestations. A family history of IBD (36.4% vs 17.5%; P = 0.006) was more common in white children. Mean erythrocyte sedimentation rate of black patients with Crohn disease was higher at diagnosis compared with whites ( P < 0.001) and a greater proportion of African Americans presented with a body mass index z ‐score less than −2 ( P < 0.009). At 12 months following diagnosis 22.5% of African American children had a hemoglobin level lower than 10 g/dL compared with 4.3% of whites ( P = 0.001). African Americans had evidence of more complicating stricturing and penetrating Crohn disease behavior (51.3% vs 27.4%; P = 0.006). African Americans received significantly more corticosteroids and infliximab to treat their IBD compared with whites ( P < 0.04). Conclusions: This study suggests that for pediatric IBD, there may be racial differences in prevalence of family history and in disease phenotype.