Clinical features and natural history of ulcerative colitis in Korea.
BACKGROUND
The clinical characteristics of ulcerative colitis (UC) in Asian populations have not been well characterized. We therefore investigated the clinical features and natural history of UC in Korea.


METHODS
We retrospectively analyzed 304 Korean patients with UC first diagnosed at the Asan Medical Center between June 1989 and August 2005.


RESULTS
The male-to-female ratio of the patients was 0.94:1, and their median age at diagnosis was 40.0 years (range, 12-72 years). At diagnosis, proctitis was noted in 134 patients (44.1%), left-sided colitis in 69 patients (22.7%), and extensive colitis in 101 patients (33.2%). Disease activity at diagnosis was mild in 149 patients (49.0%), moderate in 125 patients (41.1%), and severe in 26 patients (8.6%). In addition, 4 asymptomatic patients (1.3%) were detected as a result of a screening colonoscopy. Clinical remission after the first attack was documented in 97.4% of patients. The cumulative relapse rate after 1, 5, and 10 years was 30.2%, 72.0%, and 88.4%, respectively. The cumulative risk of proximal extension in patients with proctitis or left-sided colitis was 33.0% after 5 years and 44.5% after 10 years. The cumulative probability of colectomy was 2.0% after 1 year, 2.8% after 3 years, and 3.3% after 5 to 15 years. The cumulative survival rate after 1, 5, and 10 years was 100%, 99.4%, and 97.4%, respectively.


CONCLUSIONS
The clinical features of Korean UC patients at diagnosis are similar to those of Westerners. However, UC in Koreans may have a milder course than in Westerners, as indicated by the lower rate of colectomy among Koreans.
Park
Sang Hyoung
SH
Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
Kim
Young Min
YM
Yang
Suk-Kyun
SK
Kim
Sai-Hui
SH
Byeon
Jeong-Sik
JS
Myung
Seung-Jae
SJ
Cho
Yun Kyung
YK
Yu
Chang-Sik
CS
Choi
Kwi-Sook
KS
Chung
Jun-Won
JW
Kim
Benjamin
B
Choi
Kee Don
KD
Kim
Jin-Ho
JH
D000293:Adolescent; D000328:Adult; D000368:Aged; D044466:Asian People; D002648:Child; D003093:Colitis, Ulcerative / Q000175:diagnosis / Q000208:ethnology* / Q000503:physiopathology*; D018450:Disease Progression; D005260:Female; D006801:Humans; D007723:Korea / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies