Digestive Diseases and Sciences

, Volume 54, Issue 1, pp 142–150

Disease Behavior in Children with Crohn’s Disease: The Effect of Disease Duration, Ethnicity, Genotype, and Phenotype

  • Ron Shaoul
  • Amir Karban
  • Shimon Reif
  • Batia Weiss
  • Raanan Shamir
  • Ada Tamir
  • Ofir Davidovich
  • Jonathan Halevi
  • Esther Leshinsky Silver
  • Arie Levine
Original Article

DOI: 10.1007/s10620-008-0326-7

Cite this article as:
Shaoul, R., Karban, A., Reif, S. et al. Dig Dis Sci (2009) 54: 142. doi:10.1007/s10620-008-0326-7

Abstract

Background Disease behavior in Crohn’s disease (CD) may be modified by disease location and genotype. Disease behavior may change over time, and thus analysis requires follow-up. To date, there have been few pediatric studies that have evaluated the association between disease behavior and genotype with prolonged follow-up. The aim of our study was to evaluate the effect of genotype, phenotype, and ethnicity on disease behavior in pediatric CD. Methods Evaluation of 128 pediatric CD was followed by analysis of 232 pediatric and adult-onset CD patients. Inclusion required at least 2 years of follow-up. Phenotype, ethnicity, and disease duration were recorded. Patients were genotyped for polymorphisms in the NOD2/CARD15 gene. Results Colonic involvement was more frequent in younger patients. Pediatric disease at end of follow-up was classified as inflammatory (78%), penetrating (7%), and stricturing (17%). Duration of follow-up (mean 4.9 pediatric and 6.4 years mixed) was associated with more stricturing and penetrating disease. There was no association between mean age of onset and NOD2/CARD15, or either of these with disease behavior. These observations were replicated in the mixed cohort. Sephardic Jewish origin was inversely correlated with inflammatory behavior (P = 0.006), independent of NOD2/CARD15 genotype. Conclusions Duration of disease and ethnicity, irrespective of NOD2/CARD15 genotype and age of onset, were the only predictors for penetrating or stricturing disease.

Keywords

Crohn’s disease Genotype Phenotype Montreal classification Stricture Fistula Child NOD2 

Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • Ron Shaoul
    • 1
    • 2
  • Amir Karban
    • 2
    • 3
  • Shimon Reif
    • 4
    • 5
  • Batia Weiss
    • 5
    • 6
  • Raanan Shamir
    • 2
    • 7
  • Ada Tamir
    • 2
    • 8
  • Ofir Davidovich
    • 9
  • Jonathan Halevi
    • 5
    • 10
  • Esther Leshinsky Silver
    • 10
  • Arie Levine
    • 5
    • 10
  1. 1.Pediatric Day Care Unit, Pediatric Gastroenterology Units, Department of PediatricsBnai Zion Medical CenterHaifaIsrael
  2. 2.Faculty of MedicineTechnionHaifaIsrael
  3. 3.Gastroenterology DivisionRambam Medical CenterHaifaIsrael
  4. 4.Dana Children HospitalTel AvivIsrael
  5. 5.Sackler Faculty of MedicineTel Aviv UniversityTel AvivIsrael
  6. 6.Safra Childrens HospitalTel AvivIsrael
  7. 7.Meyer Childrens HospitalRambam Medical CenterHaifaIsrael
  8. 8.Department of Community MedicineTechnionHaifaIsrael
  9. 9.Department of Computer ScienceTel Aviv UniversityTel AvivIsrael
  10. 10.Molecular Genetics Laboratory, Pediatric Gastroenterology UnitE. Wolfson Medical CenterHolonIsrael

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