Published online May 7, 2022. doi: 10.3748/wjg.v28.i17.1830
Peer-review started: November 3, 2021
First decision: December 26, 2021
Revised: January 3, 2022
Accepted: March 25, 2022
Article in press: March 25, 2022
Published online: May 7, 2022
There remains a dearth of Asian epidemiological literature for paediatric inflammatory bowel disease (PIBD).
To describe the presenting features of PIBD from 7 Asia-Pacific pediatric gastroenterology centers via a central standardised electronic data platform.
Clinical, endoscopic and radiologic data at diagnosis from the registry were extracted between 1st January 1995 to 31st December 2019. Disease phenotypic characteristics were classified as per the Paris classification system.
There was a distinct rise in new PIBD cases: Nearly half (48.6%) of the cohort was diagnosed in the most recent 5 years (2015-2019). The ratio of Crohn’s disease (CD):Ulcerative colitis (UC):IBD-Unclassified was 55.9%:38.3%:5.8%. The mean age was 9.07 years with a high proportion of very early onset IBD (VEO-IBD) (29.3%) and EO-IBD (52.7%). An over-representation of the Indian/South Asian ethnic group was observed which accounted for 37.0% of the overall Singapore/Malaysia subcohort (6.8%-9.0% Indians in census). Indian/South Asian CD patients were also most likely to present with symptomatic perianal disease (P = 0.003). CD patients presented with significantly more constitutional symptoms (fever, anorexia, malaise/fatigue and muscle-wasting) than UC and higher inflammatory indices (higher C-reactive protein and lower albumin levels).
We observed a high incidence of VEO-IBD and an over-representation of the Indian ethnicity. South Asian CD patients were more likely to have symptomatic perianal disease.
Core Tip: We describe the presenting features of paediatric inflammatory bowel disease (IBD) in 7 paediatric gastroenterology centers across six Asia-Pacific regions via a centrally-hosted electronic data capture platform. Clinical, endoscopic and radiologic data of 311 paediatric patients diagnosed with IBD between 1995 and 2019 were extracted. The ratio of Crohn’s (CD):Ulcerative colitis:IBD-Unclassified was 55.9%:38.3%:5.8%. The mean age was 9.07 years with a high proportion of very early onset IBD (VEO-IBD) and EO-IBD. An over-representation of the Indian/South Asian ethnic group was observed in the multiethnic subpopulations of Singapore and Malaysia. Patients of Indian/South Asian ethnicity were also most likely to present with symptomatic perianal CD.