Inflammatory bowel disease in African American children compared with other racial/ethnic groups in a multicenter registry.
OBJECTIVE
Few epidemiologic investigations characterize inflammatory bowel disease (IBD) in non-Caucasian children. Our study compared IBD characteristics between African Americans and non-African Americans enrolled in a multicenter pediatric IBD registry with endoscopic- and pathology-based diagnosis.


METHODS
The study retrieved data entered from January 2000 to October 2003 on children 1 to 17 years old, inclusive, followed by a consortium of academic and community US pediatric gastroenterology practices. Analyses examined racial/ethnic differences by comparing the proportions of African Americans and non-African Americans in the following categories: each diagnostic disease classification (any IBD, Crohn's disease, ulcerative colitis, indeterminate colitis); age group (<6 y, 6-12 y, or >12 y) at diagnosis or symptom onset; presence of extraintestinal manifestations, Z-scores for height and weight, immunomodulatory therapy, anatomic disease location, and abnormal hemoglobin, albumin, or sedimentation rate at diagnosis.


RESULTS
A total of 1406 patients had complete data, 138 (10%) of whom were African American. African Americans more often were older than 12 years of age at diagnosis (52% vs 37%; odds ratio [OR], 1.82; 95% confidence interval [95% CI], 1.28-2.59) and symptom onset (46% vs 30%; OR, 1.99; 95% CI, 1.40-2.84); had Crohn's disease (78% vs 59%; OR, 2.36; 95% CI, 1.56-3.58); and had a low hemoglobin level at diagnosis (39% vs 17%; OR, 3.15; 95% CI, 1.92-5.17).


CONCLUSIONS
IBD in African American children and adolescents presents more commonly with Crohn's disease and at older ages compared with non-African Americans. Racial/ethnic differences in the epidemiology of IBD, particularly Crohn's disease, among American youths require further investigation.
Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia 30322, USA.
Jolanda M
JM
White
Siobhán
S
O'Connor
Harland S
HS
Winter
Melvin B
MB
Heyman
Barbara S
BS
Kirschner
George D
GD
Ferry
Stanley A
SA
Cohen
Robert N
RN
Baldassano
Terry
T
Smith
Traci
T
Clemons
Benjamin D
BD
Gold
D000293:Adolescent; D000367:Age Factors; D000740:Anemia / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D005006:Ethnicity; D005260:Female; D006801:Humans; D007223:Infant; D015212:Inflammatory Bowel Diseases / Q000150:complications / Q000453:epidemiology* / Q000473:pathology; D008297:Male; D014481:United States / Q000453:epidemiology