Increased Risk of Herpes Zoster in Young and Metabolically Healthy Patients with Inflammatory Bowel Disease: A Nationwide Population-Based Study

( Hosim Soh ),( Jaeyoung Chun ),( Kyungdo Han ),( Seona Park ),( Gukhwan Choi ),( Jihye Kim ),( Jooyoung Lee ),( Jong Pil Im ),( Joo Sung Kim ) 대한간학회 2019 Gut and Liver Vol.13 No.3

Background/Aims: The risk of herpes zoster (HZ) among patients with inflammatory bowel disease (IBD) remains unclear in terms of age and metabolic comorbidities, including diabetes mellitus, hypertension, or dyslipidemia. We conducted a nationwide population-based study to investigate the risk of HZ in patients with IBD. Methods: From 2010 to 2013, a retrospective study was performed using claims data in Korea. We compared the incidence of HZ between 30,100 IBD patients (10,517 Crohn’s disease [CD] and 19,583 ulcerative colitis [UC] patients) and 150,500 non-IBD controls matched by age and sex. Results: During a mean follow-up of 5.0 years, incidence rates of HZ (per 1,000 person-years) were 13.60, 14.99, and 9.19 in the CD, UC, and control groups, respectively. The risk of HZ was significantly higher in patients with CD (adjusted hazard ratio [HR], 2.13; p<0.001) and UC (adjusted HR, 1.40; p<0.001) than in the controls. The impact of CD on developing HZ was significantly more prominent in younger patients (adjusted HR, 2.61 for age <15, whereas 1.39 for age ≥60; interaction p=0.001) and in patients without metabolic comorbidities (adjusted HR, 2.24, whereas 1.59 in those with metabolic comorbidities; interaction p=0.015). Moreover, the impact of UC on developing HZ significantly increased in younger patients (adjusted HR, 2.51 in age <15, whereas 1.22 in age ≥60; interaction p=0.014) and patients without metabolic comorbidities (adjusted HR, 1.49 whereas 1.16 in those with metabolic comorbidities; interaction p<0.001). Conclusions: IBD was associated with an increased risk of HZ, especially in younger patients without metabolic comorbidities. (Gut Liver 2019;13:333-341)

Child-Pugh B or C Cirrhosis Increases the Risk for Bleeding Following Colonoscopic Polypectomy

Soh Hosim,Chun Jaeyoung,Hong Seung Wook,Park Seona,Lee Yun Bin,Lee Hyun Jung,Cho Eun Ju,Lee Jeong-Hoon,Yu Su Jong,Im Jong Pil,Kim Yoon Jun,Kim Joo Sung,Yoon Jung-Hwan 거트앤리버 소화기연관학회협의회 2020 Gut and Liver Vol.14 No.6

Background/Aims: The risk for colonoscopic postpolypectomy bleeding (PPB) in patients with chronic liver disease (CLD) remains unclear. We determined the incidence and risk factors for colonoscopic PPB in patients with CLD, especially those with liver cirrhosis. Methods: We retrospectively reviewed the medical records of patients with CLD who underwent colonoscopic polypectomy at Seoul National University Hospital between 2011 and 2014. The study endpoints were immediate and delayed PPB. Results: A total of 1,267 consecutive patients with CLD were included in the study. Immediate PPB occurred significantly more often in the Child- Pugh (CP) B or C cirrhosis group (17.5%) than in the CP-A (6.3%) and chronic hepatitis (4.6%) groups (p<0.001). Moreover, the incidence of delayed PPB in the CP-B or C cirrhosis group (4.4%) was significantly higher than that in the CP-A (0.7%) and chronic hepatitis (0.2%) groups (p<0.001). The independent risk factors for immediate PPB were CP-B or C cirrhosis (p=0.011), a platelet count <50,000/μL (p<0.001), 3 or more polyps (p=0.017), endoscopic mucosal resection or submucosal dissection (p<0.001), and polypectomy performed by trainees (p<0.001). The independent risk factors for delayed PPB were CP-B or C cirrhosis (p=0.009), and polyps >10 mm in size (p=0.010). Conclusions: Patients with CP-B or C cirrhosis had an increased risk for bleeding following colonoscopic polypectomy.

정맥경화성 대장염

소호심 ( Hosim Soh ),천재영 ( Jaeyoung Chun ) 대한소화기학회 2019 대한소화기학회지 Vol.73 No.2

Long-term outcomes of infliximab in a real-world multicenter cohort of patients with acute severe ulcerative colitis

( Shin Ju Oh ),( Ga Young Shin ),( Hosim Soh ),( Jae Gon Lee ),( Jong Pil Im ),( Chang Soo Eun ),( Kang-moon Lee ),( Dong Il Park ),( Dong Soo Han ),( Hyo Jong Kim ),( Chang Kyun Lee ) 대한장연구학회 2021 Intestinal Research Vol.19 No.3

Background/Aims: Infliximab (IFX) has proven effective as rescue therapy in steroid-refractory acute severe ulcerative colitis (ASUC), however, the long-term real-world data are scarce. Our study aimed to assess the long-term treatment outcomes of IFX in a real-life cohort. Methods: We established a multicenter retrospective cohort of hospitalized patients with ASUC, who met Truelove and Witt’s criteria and received intravenous corticosteroid (IVCS) or IFX during index hospitalization between 2006 and 2016 in 5 university hospitals in Korea. The cohort was systematically followed up until colectomy, death or last follow-up visit. Results: A total of 296 patients were followed up for a mean of 68.9±44.0 months. During index hospitalization, 49 patients were treated with IFX; as rescue therapy for IVCS failure in 37 and as first-line medical therapy for ASUC in 12. All patients treated with IFX avoided colectomy during index hospitalization. The cumulative rates of rehospitalization and colectomy were 20.4% and 6.1% at 3 months and 39.6% and 18.8% at the end of follow-up, respectively. Patients treated with IFX presented with significantly shorter colectomy-free survival than IVCS responders (P=0.04, log-rank test). Both cytomegalovirus colitis and Clostridioides difficile infection (CDI) were the significant predictors of colectomy in the overall study cohort (hazard ratios of 6.57 and 4.61, respectively). There were no fatalities. Conclusions: Our real-world cohort study demonstrated that IFX is an effective therapeutic option in Korean patients with ASUC, irrespective of IFX indication. Aggressive vigilance for cytomegalovirus colitis and CDI is warranted for hospitalized patients with ASUC. (Intest Res 2021;19:323-331)

S-35 Seasonal Variation in Acute Gastrointestinal Bleeding in Korea

( Gukhwan Choi ),( Han Myung Lee ),( Jue Lie Kim ),( Sun A Park ),( Hosim Soh ),( Min Su You ),( Gunn Huh ),( Jaeyoung Chun ),( Kyoung Sup Hong ),( Jong Pil Lim ),( Joo Sung Kim ) 대한내과학회 2016 대한내과학회 추계학술대회 Vol.2016 No.1

Background/Aims: Acute gastrointestinal bleeding (GIB) may have a seasonal variation. The aim of this study was to determine the seasonal and monthly patterns in the presentation of acute GIB in Korea. Methods: From March 2014 to February 2015, the medical records of all patients who visited the emergency room for the management of acute GIB were retrospectively reviewed. We analyzed the association between the number of patients with acute GIB and each temperature parameter. Results: A total of 716 patients with acute GIB were enrolled in this study. The study population comprised 497 males (69.4%) and 219 females (30.6%), and the mean age was 62.3 years. There were 497 (69.4%) and 219 (30.6%) patients with acute upper and lower GIB, respectively. Variceal bleeding was detected in 171 (23.9%) patients. There were significant association of the number of acute GIB with seasons (p=0.021) and months (p=0.018), respectively. The highest incidence of acute GIB was observed in spring while the lowest incidence occurred in summer. The peak number of patients with acute GIB was noticed in April and the lower plateau was observed from June to September. There was no significant correlation between the presentation of acute GIB and average temperature. However, the presentation of acute GIB showed a higher preference of daily temperature difference (correlation efficient=0.112, p=0.05) Conclusions: There is seasonal and monthly variation in the presentation of acute GIB. Acute GIB might occur more commonly in the days with higher temperature difference.

Incidence of psoriasis in patients with inflammatory bowel disease: A nationwide population-based study

( Ui Hyeon Jo ),( Jung Min Moon ),( Jin Yong Lee ),( Seong-joon Koh ),( Sungchan Kang ),( Hosim Soh ),( Hyun Jung Lee ),( Jong Pil Im ),( Joo Sung Kim ),( Hyunsun Park ) 대한피부과학회 2020 대한피부과학회 학술발표대회집 Vol.72 No.1

Background: Emerging data suggest that inflammatory bowel disease (IBD) and psoriasis are associated, sharing common genetic predispositions and immunologic mechanisms. Objectives: We aimed to investigate the risk of developing psoriasis in IBD patients compared to controls without IBD. Methods: Using the Korean insurance data, patients diagnosed with Crohn’s disease(CD) or ulcerative colitis(UC) between 2005 and 2008 were age- and sex-matched 1:4 to non-IBD subjects from 2003 to 2018. We investigated newly diagnosed psoriasis from 2009 to 2018. Incidence rates were calculated and risk of psoriasis was assessed with multivariate cox regression models. Results: During nearly a decade of follow-up, 20,152 IBD patients were identified [14,619 UC and 5,533 CD]. Among them, 439 patients were newly diagnosed with psoriasis (incidence rate of 217.68 and 228.62 per 100,000 person-years for UC and CD, respectively). The psoriasis risk was higher in IBD patients than in the matched controls (aHR 2.95, 95% CI 2.60-3.33). Moreover, IBD patients aged <30 years were at a higher risk (aHR 3.35; 95% CI, 2.58-4.35). Sensitivity analysis of tumor necrosis factor inhibitor-naïve patients revealed consistent results. Conclusion: IBD patients were more likely to develop psoriasis compared to non-IBD subjects, with younger patients at a particular risk. Inspection of cutaneous manifestation and dermatological consultation may be helpful in IBD patients at risk.