APPSPGHAN 2022

Lee Way Seah

Malaysia

Professor Lee Way Seah is Senior Professor at Faculty of Medicine and Health Sciences, University Tunku Abdul Rahman (UTAR), Malaysia and Honorary Professor in Paediatrics, Department of Paediatrics, Faculty of Medicine, University Malaya, Kuala Lumpur. He specializes in childhood GI and liver disease and nutritional issues. His main research interest is pediatric inflammatory bowel disease, neonatal and childhood liver disease, and childhood nutrition. He is a past President of College of Paediatrics, Academy of Medicine of Malaysia, as well as a Commonwealth Scholar and a Fulbright Scholar. He is currently a council member of Asian Pan-Pacific Society for Pediatric Gastroenterology, Hepatology and Nutrition (APPSPGHAN). Professor Lee has published more than 110 articles in academic journals as well as edited 4 textbooks in general paediatrics and paediatric gastroenterology/hepatology.

APPSPGHAN PIBD working group POSITION PAPER: Management and monitoring in Asia Pacific Region

Gastro Symposium (Day 2)

14 October 2022 (1500-1630) @ Sipadan Hall 1

The incidence of pediatric inflammatory bowel disease (PIBD) is rising rapidly in many industrialised and affluent areas in the Asia Pacific region. There are obvious differences in disease characteristics of PIBD between Asian and Caucasian children. Current available guidelines, mainly from Europe and North America, may not be completely applicable to clinicians caring for children with PIBD in this region due to differences in disease characteristics and regional resources constraints. Many parts of Asia are endemic for tuberculosis, making diagnosis and management of pediatric Crohn’s disease a challenge. In some populations in Asia, the Nudix Hydrolase 15 (NUD15) gene is a better predictor of leukopenia induced by azathioprine than thiopurine-S-methyltransferase (TPMT). The main considerations in the use of biologics in the Asia Pacific region are high cost, ease of access, and potential infectious risk, especially tuberculosis. This Position Paper is an initiative from the APPSPGHAN with the aim of providing an up-to-date, evidence-based approach to PIBD in the Asia Pacific region. A group of pediatric gastroenterologists with special interest in PIBD performed an extensive literature search covering epidemiology, disease characteristics and natural history, management and monitoring. Attention was paid to publications from the region with special consideration to a resource-limited setting. This Position Paper concentrates on medical and surgical management, disease monitoring, complications, immunization, bone health and nutritional issues of PIBD in Asia. A special section on differentiating pediatric Crohn’s disease and management of tuberculosis in children with IBD is included. Conclusion: This Position Paper provides a useful guide to clinicians in the management of children with PIBD in the Asia Pacific region.

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