R.0382
Epidemiology of Inflammatory Bowel Disease in the pediatric East Indian
population of British Columbia
Pinsk, V; Lemberg, D; Schreiber, R;
Barker, C; Israel, D; Jacobson, K
British Columbia Children's Hospital,
Pediatrics, Division of Gastroenterology, Vancouver, CANADA
Background: Inflammatory bowel disease (IBD) has dynamic epidemiology with increasing incidence rates of ulcerative colitis (UC) and Crohn's disease (CD) linked to ethnicity and geography. The geographical differences, population migration and changing epidemiology suggest an environmental role in prevalence, modulation and phenotypic expression of the diseases. Aim: To determine the prevalence and phenotypic expression of IBD in the pediatric East Indian immigrant population in BC diagnosed between years 1985 and 2004 with comparison to the general pediatric IBD population in the same geographic area. Methods: A retrospective review was undertaken with data collected from medical charts of East Indian Pediatric patients aged 16 years of less diagnosed with IBD at BCCH between 1985 and 2004. Comparisons were made between the East Indian Pediatric patients and the total pediatric IBD population. Age, gender, family history of IBD, type and extent of disease were included in the BCCH pediatric IBD database. Provincial population statistics were obtained from Statistics Canada. The diagnosis and classification of disease was based on clinical, endoscopic, radiological and histological criteria. Results: 62 East Indian patients were diagnosed with IBD from 1985 to 2004 (11% of total pediatric IBD population of BC); 31 (50%) with CD, 23 (37.1%) UC and 8 (12.9%) indeterminate Colitis (IC), in contrast to 65.2%, 17.1% and 17.7% respectively in the total population. The incidence rates for IBD between years 1996-2001 for the East Indian population was 14.06/105 (6.80/105 for CD, 5.44/105 for UC and 1.81/105 for IC) vs. 5.5/105 for the total IBD group (3.8/105 for CD, 0.91/105 for UC and 0.79/105 for IC). The East Indian male/female ratio was significantly different from that observed with the total population (2.15:1 vs. 1.22:1, p<0.04). A family history of IBD was evident in 29% of East Indian children compared to 36.6% of the general pediatric IBD population. No first degree East Indian relatives had CD and only 27% of second degree relatives had CD. The East Indian population had more colonic disease, however significant differences were not observed with extent of CD, age of diagnosis or duration of symptoms prior to diagnosis. Conclusions: This data suggests a significantly higher incidence of IBD in the East Indian pediatric population compared to the general pediatric population of BC, with a different pattern of phenotypic expression and male predominance. Moreover, this data indicates a difference in phenotypic expression from previously published East Indian adult IBD data. These results suggest an effect of migration, environmental and life style change on the incidence and phenotypic expression of IBD.
Topics
H IBD