Current status of Crohn's disease in Korea

Song, In Sung; Chang, Dong Kyung; Kim, Chung Yong

Abstract

OBJECTIVES
Recently, incidence of Crohn's disease appears to increase in Korea rapidly. To know the current status of Crohn's disease and to disclose characteristic clinical features in Korea, we performed this study.
METHODS
We retrospectively reviewed medical records of 117 cases of Crohn's disease registered in Seoul National University Hospital spanning between 1975 and 1996.
RESULTS
The number of the annually diagnosed cases has increased upto 10-folds since 1987 than before. The male to female ratio was 1.6 : 1 and the mean age of onset was 22. With regard to location, small intestinal disease was 23%; colonic, 21%; and mixed, 56%. Abdominal pain (97%) was a major symptom, and weight loss (88%), diarrhea (85%), and arthralgia (12%) followed it. However, other extraintestinal manfestations were very rare. Forty five percent of cases had a history of anti-tuberculous medication. Medical treatment was applied in 73% at the time of diagnosis; the outcomes of medical treatment were improvement (81%), switch to operation (9%), stationary (9%) and death (1%). Short- term outcome was worse in cases with internal fistula and elevated ESR. Symptomatic cumulative relapse rates were 20% in 1 year, 34% in 2 years, and 62% in 5 years. In view of long-term course, remission was in 17%; low-grade symptom, 31%; and actively alternating relapse-remission, the rest.
CONCLUSION
Crohn's disease in Korea seemed to be apparently increasing. The extraintestinal manifestations and rectal involvement were rare as compared with previous reports of Western countries. Forty five percent of cases had history of antituberculous medication under the impression of intestinal tuberculosis at initial diagnosis.