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.