Clinical Features of Crohn's Disease in Korea

Kim, Chan Gyoo; Kim, Ji Won; Kim, Hyeon Dae; Kim, Sang Gyun; Kim, Joo Sung; Jung, Hyun Chae; Song, In Sung

Abstract

BACKGROUND/AIMS: In Korea, Crohn's disease is rare and only few studies about clinical features have been reported. To evaluate the clinical features of Crohn's disease in Korea, we performed this clinical study.
METHODS
We retrospectively reviewed the medical records of 213 patients with Crohn's disease registered in Seoul National University Hospital between 1975 and 2000.
RESULTS
The ratio of annually diagnosed Crohn's disease to ulcerative colitis has increased from 0.2% before 1990 to more than 0.5% in 1995. The male/female ratio was 1.8:1, and the age of onset peaked in the teens. Forty-three percentages of the cases had a history of taking anti-tuberculous medications. The disease locations were the small bowel in 19% of the cases, colon in 23%, and both of the small bowel and colon in 58%. Major symptoms were abdominal pain (93%), weight loss (86%), and diarrhea (73%). Serum antibody to Saccharomyces cerevisiae were positive in 50%. Regarding the outcomes of medical treatment, 86% of the treated group showed improvement, but the remaining 14% showed poor response. Among the 24 cases of non-responding group, 13 cases received operation and 10 cases maintained the treatment. Short-term outcome was poor in cases with internal fistula. Cumulative symptomatic relapse rates were 62% in 5 years, and 88% in 10 years. Long-term clinical courses were remission in 24% of the cases, mildly symptomatic in 21%, and in a state of repetitive relapse and remission in 55%.
CONCLUSIONS
Crohn's disease in Korea seems to be apparently increasing. After a long-term course, patients are more likely to be mildly symptomatic or in a state of repetitive relapse-remission.