April 2010 Newsletter

Karen Sethi, M.D.

Dr. Sethi is exploring the potential to use the Vienna Classification as a tool to describe the behavior of Crohn’s Disease in the pediatric population. The classification is based on disease behavior proposed in 1998 at the World Gastroenterology meeting in Vienna which allows for consistency of classification based on age at diagnosis, location and behavior. It has never been used to describe the pediatric population and no other disease classification exists based on solely objective findings to differentiate disease type in a pediatric population.

The adult classification is broken down in to patients older or younger than 40 years of age; locations stratified into terminal ileum, colon, ileocolon and upper gastrointestinal; and the behavior of adult Crohn's disease into either non-stricturing, non-penetrating, stricturing or penetrating.  The goal is a retrospective study to classify pediatric Crohn's disease based on the creation of an amended Vienna classification in which to analyze correlations between sexual distribution of disease based on age, location, and behavior; the effect of age on disease location and behavior; and, finally, the influence of location of disease on behavior.  Ages were substratified to include 4 age subsets (0-6 years of age; 7-13 years of age; 14-18 years of age; and 19-25 years of age). An additional behavior type was added to include perianal disease (which includes perianal ulcer, fissures, or fistula) which is more commonly seen in pediatric Crohn's disease.