The disease course of children with ulcerative colitis (UC) varies substantially. Published data on predictors of disease outcomes in children remain scarce. We validate clinical predictors of outcomes in 93 children with UC in a single centre (age range: 2–18 years, minimum follow-up: 18 months). We stratified children into 3 groups according to their disease course, that is, 1 = mild (38/93, 40.9%), 2 = moderate (38/93, 40.9%), 3 = severe (17, 18.2%). Comparison of clinical and biochemical parameters was performed between groups using Chi-square, Mann-Whitney, and log-rank tests. Predictors of a severe disease course included pancolitis (P 0.01), low albumin (P 0.005), low haemoglobin at diagnosis (P 0.04), paediatric ulcerative colitis activity index (PUCAI) at 3 months, and nonresponse to steroids at 3 months (P 0.0001). In our cohort, failure to achieve remission at 3 months implied an 80% likelihood to require biologics or major surgery within 18 months. A specific 3-month review point is recommended to guide future management.
*Department of Paediatrics, University of Cambridge, Addenbrooke's Hospital
†Department of Paediatric Gastroenterology, Hepatology and Nutrition, Cambridge University Hospitals, Addenbrooke's, Cambridge, United Kingdom.
Address correspondence and reprint requests to Matthias Zilbauer, MD, PhD, MRCPCH, University Department of Paediatrics, Level 8 Addenbrooke's Hospital, Box 116, Hills Rd, Cambridge, CB2 0QQ UK (e-mail: firstname.lastname@example.org).
Received 12 November, 2017
Accepted 11 February, 2018
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Conflicts of Interest and Source of Funding: nothing to declare.
MG, VW-S, RH, and MZ contributed equally to this work.
MG and VW-S are the co-first authors.