Disease presentation and clinical course in black and white children with inflammatory bowel disease.

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.