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Racial differences in disease phenotypes in patients with Crohn's disease

Cross, Raymond K. MD1,4,*; Jung, Carrianne MS2; Wasan, Sharmeel MD1; Joshi, Grishma MD1; Sawyer, Robert MD3,4; Roghmann, Mary-Claire MD, MS1,2,4

doi: 10.1097/01.MIB.0000217767.98389.20
Original Articles

Background: Our objectives were to assess the differences in perforating disease behavior, disease severity, and extraintestinal manifestations (EIM) in patients with Crohn's disease (CD) by race.

Materials and Methods: We identified outpatients with CD evaluated at the University of Maryland Gastroenterology Faculty Practice office or the Baltimore Veterans Affairs Maryland Health Care System, from 1997 to 2005. We assessed age at diagnosis, disease behavior, disease location, need for surgery and EIM.

Results: Race was not associated with perforating disease behavior (relative risk [RR] 0.79, 95% confidence interval [CI] 0.46-1.35), need for surgery (RR 0.89, 95% CI 0.56-1.12), and EIM of CD (RR 0.77, 95% CI 0.46-1.27). White patients were significantly more likely to have ileal disease, whereas African American patients were significantly more likely to have ileocolonic and colonic disease. Age at diagnosis younger than 40 years (odds ratio [OR] 4.41, 95% CI 1.84-10.56) and ileocolonic disease (OR 2.39, 95% CI 1.24-4.63) were independent risk factors for perforating disease behavior. Similarly, age at diagnosis younger than 40 (OR 2.79, 95% CI 1.45-5.33), ileal disease (OR 3.76, 95% CI 1.66-8.48), and ileocolonic disease (OR 2.57, 95% CI1.21-5.46) were associated with the need for surgery. Female gender (OR 4.23, 95% CI 1.87-9.58) and a positive family history of CD (OR 3.45, 95% CI 1.49-8.0) were associated with joint manifestations of CD.

Discussion: We did not detect differences in disease behavior, severity, or joint EIM by race. Although African American patients were more likely to have ileocolonic or colonic disease, these factors did not affect disease behavior or severity.

1 Department of Medicine, Department of Surgery, University of Maryland School of Medicine, Baltimore, Maryland

2 Department of Epidemiology and Preventive Medicine, Department of Surgery, University of Maryland School of Medicine, Baltimore, Maryland

3 Division of Otorhinolaryngology, Department of Surgery, University of Maryland School of Medicine, Baltimore, Maryland

4 Veterans Affairs Maryland Heath Care System, Baltimore, Maryland

*Reprints: 22 South Greene Street, N3W62, Baltimore, Maryland 21201

Email: rcross@medicine.umaryland.edu

Received 1 November 2005; Accepted 10 December 2005

© Crohn's & Colitis Foundation of America, Inc.
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