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Impact of race and ethnicity on IBD

The most recent issue of the American Journal of Gastroenterology shows that there are significant differences in IBD subtypes and serologic markers among racial/ ethnic groups with IBD in the United States.

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Inflammatory bowel disease (IBD) is now increasingly recognized in diverse ethnic populations.

In the United States, IBD among the minority populations, especially Mexican Americans, has not been extensively studied.

The are the known genetic influences that differ among the IBD subtypes, including ulcerative colitis and Crohn's disease.

Serologic markers may differentiate ulcerative colitis and Crohn's disease.

Serologic markers also differentiate perinuclear antineutrophilic cytoplasmic antibody and anti-Saccharomyces cerevisiae antibody in ulcerative colitis and Crohn's disease.

Dr Joseph Sellin and colleagues from Texas determined whether there were significant differences among racial or ethnic groups.

The investigators included 148 patients with IBD seen in a university gastroenterology practice between 1999 and 2003.

African Americans with Crohn's had a higher incidence of IBD-associated arthritis
The American Journal of Gastroenterology

The team reported that Whites comprised 40%, African Americans 37%, Mexican Americans 20%, and Asians 3% of the total IBD patients.

The investigators found that African Americans and Whites predominantly had Crohn's disease.

The team noted that Mexican Americans predominantly had ulcerative colitis.

There was no difference between African Americans when compared to whites in terms of intestinal manifestations of Crohn's disease.

The investigators also observed no difference between Mexican Americans compared to whites in terms of intestinal manifestations of ulcerative colitis.

However, African Americans with Crohn's disease had a significantly higher incidence of IBD-associated arthritis.

The team noted that African Americans with Crohn's had a higher incidence of ophthalmological manifestations, notably uveitis, compared to whites with Crohn's.

Among ulcerative colitis patients, in comparison to the Mexican Americans, whites had significantly higher incidences of joint symptoms and osteoporosis.

The investigative team noted that whites had a stronger family history of IBD and colorectal carcinoma compared to the other ethnic groups.

Perinuclear antineutrophilic cytoplasmic antibody served as a sensitive marker for ulcerative colitis among Mexican Americans.

All the Mexican American patients with ulcerative colitis tested had positive perinuclear antineutrophilic cytoplasmic antibody vs 40% of whites.

Dr Sellin's team concludes, “There are significant differences in IBD subtypes and serologic markers among racial/ ethnic groups with IBD in the United States.”

Am J Gastroenterol 2005: 100(10) 2254
26 September 2005

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