Related Experiment Video
Updated: Oct 13, 2025
Flexible Colonoscopy in Mice to Evaluate the Severity of Colitis and Colorectal Tumors Using a Validated Endoscopic Scoring System
Published on: October 16, 2013
Severe Disease Activity Based on the Paris Classification Is Associated with the Development of Extraintestinal
Hyo-Jeong Jang1, Hyo Rim Suh2, Sujin Choi2
1Department of Pediatrics, Keimyung University School of Medicine, Daegu, Korea.
Insights
Severe disease activity in pediatric ulcerative colitis patients is linked to extraintestinal manifestations (EIMs). Focusing on disease control can minimize EIM development in children with inflammatory bowel disease (IBD).
Area of Science:
- Pediatric Gastroenterology
- Inflammatory Bowel Disease (IBD) Research
- Clinical Epidemiology
Background:
- Limited data exists on extraintestinal manifestations (EIMs) in Korean pediatric inflammatory bowel disease (IBD) patients.
- Understanding EIMs is crucial for comprehensive IBD management in children and adolescents.
Purpose of the Study:
- To investigate the clinical features of EIMs in Korean pediatric IBD patients.
- To identify factors associated with the development of EIMs in this population.
Main Methods:
- A multicenter, retrospective study from 2010 to 2017.
- Inclusion of 172 pediatric patients diagnosed with IBD (Crohn's disease [CD] or ulcerative colitis [UC]).
- Analysis of clinicodemographic data, laboratory findings, disease activity, phenotypes, and EIMs.
Main Results:
- EIMs occurred in 24.4% of pediatric IBD patients (24.8% with CD, 22.9% with UC).
- Arthritis/arthralgia was the most frequent EIM (35.7%), followed by stomatitis/oral ulcer (23.8%).
- Severe disease activity based on the Paris classification was significantly associated with EIM development in UC patients (OR, 16.57; P = 0.017).
Conclusions:
- Severe disease activity in pediatric ulcerative colitis is a significant risk factor for EIM development.
- The Paris classification's dynamic nature highlights the importance of aggressive disease control.
- Treatment strategies should prioritize minimizing EIM occurrence by managing disease severity in Korean pediatric IBD patients.
Background:
There are limited data regarding the extraintestinal manifestations (EIMs) associated with pediatric inflammatory bowel disease (IBD) in Korea. We aimed to investigate the clinical features and factors associated with the development of EIMs in Korean children and adolescents with IBD.
Methods:
This multicenter, retrospective study was conducted from 2010 to 2017. Baseline clinicodemographic, laboratory findings, disease activity, disease phenotypes, and EIMs were investigated.
Results:
A total of 172 patients were included. One-hundred thirty-seven (79.7%) had Crohn's disease (CD), and 35 (20.3%) had ulcerative colitis (UC). EIMs occurred in 42 patients (24.4%). EIMs developed in 34/137 diagnosed with CD (24.8%), and in 8/35 diagnosed with UC (22.9%), during a median follow-up duration of 3.2 (interquartile range, 1.9-5.4) years for CD and 3.0 (1.0-4.0) years for UC, respectively. Arthritis/arthralgia was most commonly observed (n = 15, 35.7%), followed by stomatitis/oral ulcer (n = 10, 23.8%), hepatitis (n = 5, 11.9%), nephritis (n = 4, 9.5%), pancreatitis (n = 2, 4.8%), erythema nodosum (n = 2, 4.8%), pyoderma gangrenosum (n = 1, 2.4%), primary sclerosing cholangitis (n = 1, 2.4%), uveitis (n = 1, 2.4%), and ankylosing spondylitis (n = 1, 2.4%). A significant difference in disease severity based on the Paris classification (P = 0.011) and ESR at diagnosis (P = 0.043) was observed between the EIM positive and negative group in patients with UC. According to logistic regression analyses, S1 disease severity based on the Paris classification was the only factor that was significantly associated with the development of EIMs (odds ratio, 16.57; 95% confidence interval, 2.18-287.39; P = 0.017).
Conclusion:
Severe disease activity based on the Paris classification in pediatric patients with UC was significantly associated with EIM development. As disease severity in the Paris classification is a dynamic parameter, treatment should be focused on disease control to minimize the occurrence of EIMs in Korean children and adolescents with UC.
Related Concept Videos
01:27Inflammatory Bowel Disease I: Ulcerative Colitis
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
01:17Chronic Bowel Disorders: Introduction
Irritable Bowel Syndrome (IBS) is a common disorder affecting the gastrointestinal tract. The distinctive feature is recurrent abdominal pain associated with altered bowel movements, manifesting as constipation, diarrhea, or fluctuating between both. The...
01:30Inflammatory Bowel Disease II: Crohn's Disease
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by...
01:28Peptic Ulcer Disease III: Clinical Manifestations and Diagnostic Studies
Few clinical manifestations differentiate gastric ulcers from duodenal ulcers. Distinctions in the location, timing, and pain relief are crucial for healthcare providers in differentiating between gastric and duodenal ulcers during clinical assessments.
01:30Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the...
01:29Drugs for Treatment of Ulcerative Colitis in IBD