%0 Journal Article
%A Ledder, Oren
%A Church, Peter
%A Cytter-Kuint, Ruth
%A Martínez-Leon, Maria
%A Sladek, Malgorzata
%A Coppenrath, Eva
%A Weiss, Batia
%A Yerushalmi, Baruch
%A Martin-de-Carpi, Javier
%A Duchano, Larisa
%A Towbin, Alexander
%A Assa, Amit
%A Shaoul, Ron
%A Mearin, M L
%A Alex, George
%A Griffiths, Anne
%A Turner, Dan
%T A Simple Endoscopic Score Modified for the Upper Gastrointestinal Tract in Crohn's Disease [UGI-SES-CD]: A Report From the ImageKids Study.
%D 2018
%U http://hdl.handle.net/10668/12506
%X There is no standardized endoscopic description of upper gastrointestinal [UGI] disease in Crohn's disease [CD]. We prospectively applied the Simple Endoscopic Score for CD [SES-CD] to the UGI tract as a planned sub-study of the multicentre prospective ImageKids study. We aimed to assess the utility of the UGI-SES-CD and its clinical significance in paediatric CD. Patients underwent an oesophagogastroduodenoscopy [EGD], ileocolonoscopy, and magnetic resonance enterography [MRE] with explicit clinical data recorded. SES-CD was scored at each region [oesophagus, stomach body, antrum, and duodenum]. Half of the patients were followed for 18 months, when a repeat MRE was performed. A total of 202 children were included 56% males, mean age 11.5 ± 3.2 years, median weighted Paediatric Crohn's Disease Activity Index [wPCDAI 25]). UGI-SES-CD score ranged 0-17, with 95 [47%] having a UGI-SES-CD ≥1; no narrowing was detected. UGI-SES-CD ≥1 was associated with higher: wPCDAI [32.5 vs 20; p = 0.03]; Physician's Global Assessment [PGA] of inflammation (45 mm visual analogue score [VAS] vs 30 mm VAS; p = 0.04); ileocolonoscopic SES-CD [10 vs 7; p = 0.004], faecal calprotectin [717 µg/g vs 654 µ/g; p= 0.046]; and radiological global assessment of damage by MRE [7 mm VAS vs 0; p = 0.04]. In all, 81 patients were followed for 18 months and no association was identified between initial UGI SES-CD and markers of disease course such as surgery, MRE assessment, or treatment escalation. UGI-SES-CD is an easily reported objective scoring system and is associated with a more severe disease phenotype but not with disease course.
%K Crohn’s disease
%K Endoscopy
%K Paediatric
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