P009 A comparison of pediatric vs adult onset IBD in Puerto Rican Hispanics

BACKGROUND: The IBD Registry collects demographic and medical information of patients with confirmed ulcerative colitis (UC) and Crohn's disease (CD). The 4-fold increase in IBD in Puerto Rico including children warrants exploration of this population. The aim is to describe clinical features of IBD in pediatric vs adult onset Puerto Ricans. METHODS: This is a cross-sectional study in where registry entries from 1995 to 2018 were analyzed for demographics, medical information, family history, extra-intestinal manifestations, surgery, duration of disease and interval between symptom onset and diagnosis using ANOVA. Data was divided into pediatric onset (age of onset ≤18 years old), and adult onset IBD (≥19 years old), then each group was subdivided by disease, CD and UC. The IBD Registry is approved by the Medical Sciences Campus IRB. RESULTS: Nine hundred Seven Puerto Ricans with IBD, 541 (59.7%) with CD and 366 (40.3%) with UC, were included. Three hundred fifty-five (39.1%) were pediatric onset and 552 (60.9%) adult onset IBD. Mean age of onset was 31.6 ± 11.6 in adult onset and 14.1 ± 3.8 in pediatric onset patients. Two hundred ninety-five patients had at least one extra-intestinal manifestation, 40.5% in the adult onset and 20% in the pediatric onset group. Arthritis was the most common extra-intestinal manifestation in both groups. Family history of IBD was present in 33.5% and 18.7% of pediatric and adult onset, respectively ( P = 0.2). Pediatric onset subjects had a higher prevalence of remote relatives with IBD (21.3% vs 13.2% of the adults, P < 0.05). 71.4% of the adult onset IBD patients and 36.6% of the pediatric had ≤5 years with disease. Interval less than 1 year between onset of symptoms and diagnosis in the pediatric group was 55% for UC and 45.1% for CD. For the adult group, 64.2% and 51.5% of UC and CD respectively were diagnosed within a year. Prevalence of surgery was 30.9% and 55.8% for all UC and CD respectively ( P = 0.002); and 47.3% for pediatric and 44.7% for adults ( P = 0.6). CONCLUSION(S): Significant differences between pediatric and adult onset Puerto Ricans with IBD were a higher prevalence of EIM in adults and a higher proportion of non-first-degree relatives with IBD in pediatrics. As expected, the prevalence of surgery was higher in patients with CD than in patients with UC in both groups. The majority of patients had 5 years or less of disease and were diagnosed within 1 year of the onset of symptoms. This study contributes to a better understanding of the epidemiology of IBD in Puerto Rican Hispanics.