Features and Outcomes of Children with Ulcerative Colitis who Undergo a Diagnostic Change: A Single-Center Experience

Abstract

Purpose A change in diagnosis from ulcerative colitis (UC) to Crohn's disease (CD) has been reported in pediatric inflammatory bowel disease; however, only a few clinical characteristics and predictors of this diagnostic change have been reported. We aimed to describe the clinical characteristics of patients with UC who underwent a change in diagnosis to CD and identify variables associated with the change. Methods The medical records of pediatric patients with UC who were followed up at the National Center for Child Health and Development between 2006 and 2019 were retrospectively reviewed. Clinical data on disease phenotype, laboratory parameters, endoscopic findings, and treatment of patients whose diagnosis changed to CD (cCD) were compared to those of patients whose diagnosis remained UC (rUC). Results Among the 111 patients initially diagnosed with UC, 11 (9.9%) patients were subsequently diagnosed with CD during follow-up. There was no significant difference between the cCD and rUC groups in terms of sex, age at initial diagnosis, and the extent and severity of disease at initial diagnosis. Albumin and hemoglobin levels were significantly lower in the cCD group than in the rUC group. The proportion of patients who required biologics was significantly higher in the cCD group than in the rUC group ( p <0.05). Conclusion Approximately 10% children initially diagnosed with UC were subsequently diagnosed with CD. Hypoalbuminemia and anemia at initial diagnosis and use of biologics could be predictors of this diagnostic change.

Long-Term Efficacy and Safety of Golimumab for Ulcerative Colitis in a Pediatric Inflammatory Bowel Disease Center in Japan

“…In Norway, 14% of patients with UC are diagnosed with CD within 5 years [ 29 ]. Ten percent of children initially diagnosed with UC were subsequently diagnosed with CD [ 30 ]. In the present study, the diagnoses in three cases were changed from UC to CD.…”

Concurrent Hydrocephalus and Ulcerative Colitis: Exploring the Role of IL18: A Case Report

“…Bloody diarrhea, the initial symptom in our case, is commonly associated with various causes, including infectious enteritis, anal fissures, and IBD [7]. Thorough initial evaluation, beyond colonoscopy, is essential, particularly when hypoalbuminemia and anemia coexist, serving as predictors of subsequent changes in diagnosis [8,9]. Pediatric UC poses challenges to growth, nutritional status, and psychosocial development, necessitating therapies for remission induction and maintenance, cancer prevention, and improved quality of life [10].…”