De Novo Crohn's Disease in Children With Ulcerative Colitis Undergoing Ileal Pouch-Anal Anastomosis: A Multicenter, Retrospective Study From the Pediatric IBD Porto Group of the ESPGHAN

M Martinelli; E Romeo; T Caldaro; K Dimakou; A Papadopoulou; M Matar; A Assa; V Dipasquale; C Romano; M Aloi; P Alvisi; D Röser; KL Kolho; N Afzal; O Ledder; S Cohen; J Bronsky; JC Escher; A Brueckner; R Shamir; A Staiano; E Miele

doi:10.1093/ibd/izad199

De Novo Crohn's Disease in Children With Ulcerative Colitis Undergoing Ileal Pouch-Anal Anastomosis: A Multicenter, Retrospective Study From the Pediatric IBD Porto Group of the ESPGHAN

M Martinelli
, E Romeo
, T Caldaro
, K Dimakou
, A Papadopoulou
, M Matar
, A Assa
, V Dipasquale
, C Romano
, M Aloi
, P Alvisi
, D Röser
, KL Kolho
, N Afzal
, O Ledder
, S Cohen
, J Bronsky
, JC Escher
, A Brueckner
, R Shamir

A Staiano^*, E Miele

^*Corresponding author for this work

Pediatrics

University of Naples Federico II
IRCCS Ospedale pediatrico Bambino Gesù - Roma
Children’s Hospital Agia Sofia
University of Athens
Tel Aviv University
Hebrew University of Jerusalem
University of Messina
University of Rome La Sapienza
Hospital Maggiore di Lodi
Copenhagen University Hospital (Nordvest)
University of Helsinki
Southampton Children’s Hospital
University of Portsmouth
Motol University Hospital
Ludwig Maximilian University of Munich
Schneider Childrens Medical Center Israel
Dana-Dwek Children’s Hospital
Tel Aviv Sourasky Medical Center

Research output: Contribution to journal › Article › Academic › peer-review

9 Citations (Scopus)

42 Downloads (Pure)

Abstract

Background and Aims:

We sought to define the prevalence and to characterize possible predictive factors of Crohn’s disease (CD) occurring in children with ulcerative colitis (UC) after ileal pouch–anal anastomosis (IPAA).

Methods:

This was a multicenter, retrospective study including 15 centers of the Porto IBD group of the European Society for Pediatric Gastroenterology, Hepatology and Nutrition. Children with a confirmed diagnosis of UC undergoing colectomy with IPAA and a minimal follow up of 6 months were identified. The following data were collected: demographic data; endoscopic and histologic data; disease activity; laboratory exams; therapeutic history; indication for surgery, type, and timing; and IPAA functional outcomes and complications. In de novo CD cases, time of diagnosis, phenotype, location, and therapies were gathered.

Results:

We identified 111 UC children undergoing IPAA from January 2008 to June 2018 (median age at colectomy: 13 years; age range: 1-18 years; female/male: 59/52). The median time from diagnosis to colectomy was 16 (range, 0-202) months. At the last follow-up, 40 (36%) of 111 children developed pouchitis. The criteria for de novo CD were met in 19(17.1%) of 111 children with a 25-month median (range, 3-61 months). At last follow-up, 12 (63.1%) of 19 were treated with biologics and in 5 (26.3%) of 19 children, the pouch was replaced with definitive ileostomy. In a multivariable logistic regression model, decreased preoperative body mass index z scores (odds ratio, 2.2; 95% confidence interval, 1.1-4.4; P = .01) resulted as the only variable associated with CD development.

Conclusions:

Children with UC undergoing IPAA carry a high risk of developing subsequent CD. De novo CD cases showed decreased preoperative body mass index z scores, identifying a poor nutritional status as a possible predictive factor.

Original language	English
Article number	izad199
Pages (from-to)	1475-1481
Number of pages	7
Journal	Inflammatory Bowel Diseases
Volume	30
Issue number	9
Early online date	10 Oct 2023
DOIs	https://doi.org/10.1093/ibd/izad199
Publication status	Published - 1 Sept 2024

Bibliographical note

Publisher Copyright:
© 2023 The Author(s). Published by Oxford University Press on behalf of Crohn's & Colitis Foundation. All rights reserved.

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10.1093/ibd/izad199

De Novo Crohn’s Disease in Children With Ulcerative Colitis Undergoing Ileal Pouch–Anal AnastomosisFinal published version, 213 KBLicence: Article 25fa Dutch Copyright Act

Cite this

Martinelli, M., Romeo, E., Caldaro, T., Dimakou, K., Papadopoulou, A., Matar, M., Assa, A., Dipasquale, V., Romano, C., Aloi, M., Alvisi, P., Röser, D., Kolho, KL., Afzal, N., Ledder, O., Cohen, S., Bronsky, J., Escher, JC., Brueckner, A., ... Miele, E. (2024). De Novo Crohn's Disease in Children With Ulcerative Colitis Undergoing Ileal Pouch-Anal Anastomosis: A Multicenter, Retrospective Study From the Pediatric IBD Porto Group of the ESPGHAN. Inflammatory Bowel Diseases, 30(9), 1475-1481. Article izad199. https://doi.org/10.1093/ibd/izad199

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title = "De Novo Crohn's Disease in Children With Ulcerative Colitis Undergoing Ileal Pouch-Anal Anastomosis: A Multicenter, Retrospective Study From the Pediatric IBD Porto Group of the ESPGHAN",

abstract = "Background and Aims: We sought to define the prevalence and to characterize possible predictive factors of Crohn{\textquoteright}s disease (CD) occurring in children with ulcerative colitis (UC) after ileal pouch{\textendash}anal anastomosis (IPAA). Methods: This was a multicenter, retrospective study including 15 centers of the Porto IBD group of the European Society for Pediatric Gastroenterology, Hepatology and Nutrition. Children with a confirmed diagnosis of UC undergoing colectomy with IPAA and a minimal follow up of 6 months were identified. The following data were collected: demographic data; endoscopic and histologic data; disease activity; laboratory exams; therapeutic history; indication for surgery, type, and timing; and IPAA functional outcomes and complications. In de novo CD cases, time of diagnosis, phenotype, location, and therapies were gathered. Results: We identified 111 UC children undergoing IPAA from January 2008 to June 2018 (median age at colectomy: 13 years; age range: 1-18 years; female/male: 59/52). The median time from diagnosis to colectomy was 16 (range, 0-202) months. At the last follow-up, 40 (36\%) of 111 children developed pouchitis. The criteria for de novo CD were met in 19(17.1\%) of 111 children with a 25-month median (range, 3-61 months). At last follow-up, 12 (63.1\%) of 19 were treated with biologics and in 5 (26.3\%) of 19 children, the pouch was replaced with definitive ileostomy. In a multivariable logistic regression model, decreased preoperative body mass index z scores (odds ratio, 2.2; 95\% confidence interval, 1.1-4.4; P = .01) resulted as the only variable associated with CD development. Conclusions: Children with UC undergoing IPAA carry a high risk of developing subsequent CD. De novo CD cases showed decreased preoperative body mass index z scores, identifying a poor nutritional status as a possible predictive factor.",

author = "M Martinelli and E Romeo and T Caldaro and K Dimakou and A Papadopoulou and M Matar and A Assa and V Dipasquale and C Romano and M Aloi and P Alvisi and D R{\"o}ser and KL Kolho and N Afzal and O Ledder and S Cohen and J Bronsky and JC Escher and A Brueckner and R Shamir and A Staiano and E Miele",

year = "2024",

month = sep,

day = "1",

doi = "10.1093/ibd/izad199",

language = "English",

volume = "30",

pages = "1475--1481",

journal = "Inflammatory Bowel Diseases",

issn = "1078-0998",

publisher = "Oxford University Press",

number = "9",

}

Martinelli, M, Romeo, E, Caldaro, T, Dimakou, K, Papadopoulou, A, Matar, M, Assa, A, Dipasquale, V, Romano, C, Aloi, M, Alvisi, P, Röser, D, Kolho, KL, Afzal, N, Ledder, O, Cohen, S, Bronsky, J, Escher, JC, Brueckner, A, Shamir, R, Staiano, A & Miele, E 2024, 'De Novo Crohn's Disease in Children With Ulcerative Colitis Undergoing Ileal Pouch-Anal Anastomosis: A Multicenter, Retrospective Study From the Pediatric IBD Porto Group of the ESPGHAN', Inflammatory Bowel Diseases, vol. 30, no. 9, izad199, pp. 1475-1481. https://doi.org/10.1093/ibd/izad199

De Novo Crohn's Disease in Children With Ulcerative Colitis Undergoing Ileal Pouch-Anal Anastomosis: A Multicenter, Retrospective Study From the Pediatric IBD Porto Group of the ESPGHAN. / Martinelli, M; Romeo, E; Caldaro, T et al.
In: Inflammatory Bowel Diseases, Vol. 30, No. 9, izad199, 01.09.2024, p. 1475-1481.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - De Novo Crohn's Disease in Children With Ulcerative Colitis Undergoing Ileal Pouch-Anal Anastomosis

T2 - A Multicenter, Retrospective Study From the Pediatric IBD Porto Group of the ESPGHAN

AU - Martinelli, M

AU - Romeo, E

AU - Caldaro, T

AU - Dimakou, K

AU - Papadopoulou, A

AU - Matar, M

AU - Assa, A

AU - Dipasquale, V

AU - Romano, C

AU - Aloi, M

AU - Alvisi, P

AU - Röser, D

AU - Kolho, KL

AU - Afzal, N

AU - Ledder, O

AU - Cohen, S

AU - Bronsky, J

AU - Escher, JC

AU - Brueckner, A

AU - Shamir, R

AU - Staiano, A

AU - Miele, E

PY - 2024/9/1

Y1 - 2024/9/1

N2 - Background and Aims: We sought to define the prevalence and to characterize possible predictive factors of Crohn’s disease (CD) occurring in children with ulcerative colitis (UC) after ileal pouch–anal anastomosis (IPAA). Methods: This was a multicenter, retrospective study including 15 centers of the Porto IBD group of the European Society for Pediatric Gastroenterology, Hepatology and Nutrition. Children with a confirmed diagnosis of UC undergoing colectomy with IPAA and a minimal follow up of 6 months were identified. The following data were collected: demographic data; endoscopic and histologic data; disease activity; laboratory exams; therapeutic history; indication for surgery, type, and timing; and IPAA functional outcomes and complications. In de novo CD cases, time of diagnosis, phenotype, location, and therapies were gathered. Results: We identified 111 UC children undergoing IPAA from January 2008 to June 2018 (median age at colectomy: 13 years; age range: 1-18 years; female/male: 59/52). The median time from diagnosis to colectomy was 16 (range, 0-202) months. At the last follow-up, 40 (36%) of 111 children developed pouchitis. The criteria for de novo CD were met in 19(17.1%) of 111 children with a 25-month median (range, 3-61 months). At last follow-up, 12 (63.1%) of 19 were treated with biologics and in 5 (26.3%) of 19 children, the pouch was replaced with definitive ileostomy. In a multivariable logistic regression model, decreased preoperative body mass index z scores (odds ratio, 2.2; 95% confidence interval, 1.1-4.4; P = .01) resulted as the only variable associated with CD development. Conclusions: Children with UC undergoing IPAA carry a high risk of developing subsequent CD. De novo CD cases showed decreased preoperative body mass index z scores, identifying a poor nutritional status as a possible predictive factor.

AB - Background and Aims: We sought to define the prevalence and to characterize possible predictive factors of Crohn’s disease (CD) occurring in children with ulcerative colitis (UC) after ileal pouch–anal anastomosis (IPAA). Methods: This was a multicenter, retrospective study including 15 centers of the Porto IBD group of the European Society for Pediatric Gastroenterology, Hepatology and Nutrition. Children with a confirmed diagnosis of UC undergoing colectomy with IPAA and a minimal follow up of 6 months were identified. The following data were collected: demographic data; endoscopic and histologic data; disease activity; laboratory exams; therapeutic history; indication for surgery, type, and timing; and IPAA functional outcomes and complications. In de novo CD cases, time of diagnosis, phenotype, location, and therapies were gathered. Results: We identified 111 UC children undergoing IPAA from January 2008 to June 2018 (median age at colectomy: 13 years; age range: 1-18 years; female/male: 59/52). The median time from diagnosis to colectomy was 16 (range, 0-202) months. At the last follow-up, 40 (36%) of 111 children developed pouchitis. The criteria for de novo CD were met in 19(17.1%) of 111 children with a 25-month median (range, 3-61 months). At last follow-up, 12 (63.1%) of 19 were treated with biologics and in 5 (26.3%) of 19 children, the pouch was replaced with definitive ileostomy. In a multivariable logistic regression model, decreased preoperative body mass index z scores (odds ratio, 2.2; 95% confidence interval, 1.1-4.4; P = .01) resulted as the only variable associated with CD development. Conclusions: Children with UC undergoing IPAA carry a high risk of developing subsequent CD. De novo CD cases showed decreased preoperative body mass index z scores, identifying a poor nutritional status as a possible predictive factor.

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DO - 10.1093/ibd/izad199

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SN - 1078-0998

VL - 30

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JO - Inflammatory Bowel Diseases

JF - Inflammatory Bowel Diseases

IS - 9

M1 - izad199

ER -

Martinelli M, Romeo E, Caldaro T, Dimakou K, Papadopoulou A, Matar M et al. De Novo Crohn's Disease in Children With Ulcerative Colitis Undergoing Ileal Pouch-Anal Anastomosis: A Multicenter, Retrospective Study From the Pediatric IBD Porto Group of the ESPGHAN. Inflammatory Bowel Diseases. 2024 Sept 1;30(9):1475-1481. izad199. Epub 2023 Oct 10. doi: 10.1093/ibd/izad199

De Novo Crohn's Disease in Children With Ulcerative Colitis Undergoing Ileal Pouch-Anal Anastomosis: A Multicenter, Retrospective Study From the Pediatric IBD Porto Group of the ESPGHAN

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