BACKGROUND: Our objectives were to assess the differences in perforating disease 
behavior, disease severity, and extraintestinal manifestations (EIM) in patients 
with Crohn's disease (CD) by race.
MATERIALS AND METHODS: We identified outpatients with CD evaluated at the 
University of Maryland Gastroenterology Faculty Practice office or the Baltimore 
Veterans Affairs Maryland Health Care System, from 1997 to 2005. We assessed age 
at diagnosis, disease behavior, disease location, need for surgery and EIM.
RESULTS: Race was not associated with perforating disease behavior (relative 
risk [RR] 0.79, 95% confidence interval [CI] 0.46-1.35), need for surgery (RR 
0.89, 95% CI 0.56-1.12), and EIM of CD (RR 0.77, 95% CI 0.46-1.27). White 
patients were significantly more likely to have ileal disease, whereas African 
American patients were significantly more likely to have ileocolonic and colonic 
disease. Age at diagnosis younger than 40 years (odds ratio [OR] 4.41, 95% CI 
1.84-10.56) and ileocolonic disease (OR 2.39, 95% CI 1.24-4.63) were independent 
risk factors for perforating disease behavior. Similarly, age at diagnosis 
younger than 40 (OR 2.79, 95% CI 1.45-5.33), ileal disease (OR 3.76, 95% CI 
1.66-8.48), and ileocolonic disease (OR 2.57, 95% CI1.21-5.46) were associated 
with the need for surgery. Female gender (OR 4.23, 95% CI 1.87-9.58) and a 
positive family history of CD (OR 3.45, 95% CI 1.49-8.0) were associated with 
joint manifestations of CD.
DISCUSSION: We did not detect differences in disease behavior, severity, or 
joint EIM by race. Although African American patients were more likely to have 
ileocolonic or colonic disease, these factors did not affect disease behavior or 
severity.