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Long-Term outcomes of children diagnosed with indeterminate colitis

Serenay Cetinoglu1, Betul Aksoy1, Ilksen Demir1

  • 1Department of Pediatric Gastroenterology, Hepatology and Nutrition, Faculty of Medicine, Izmir Katip Celebi University, İzmir City Hospital, Izmir, Turkey.

Arab Journal of Gastroenterology : the Official Publication of the Pan-Arab Association of Gastroenterology
|January 27, 2026
PubMed

Insights

Indeterminate colitis (IC) in children often presents with significant genetic mutations and requires careful monitoring for autoimmune conditions and potential reclassification to ulcerative colitis or Crohn's disease.

Area of Science:

  • Pediatric gastroenterology
  • Inflammatory bowel disease (IBD) research
  • Autoimmune disorders in children

Background:

  • Indeterminate colitis (IC) is a distinct subtype of inflammatory bowel disease (IBD).
  • The clinical trajectory and outcomes of pediatric IC remain incompletely understood.
  • This study aimed to define the follow-up course for children diagnosed with IC.

Purpose of the Study:

  • To evaluate the clinical outcomes of pediatric indeterminate colitis (IC).
  • To identify associated autoimmune conditions and genetic factors in children with IC.
  • To assess the long-term disease course and potential reclassification of IC.

Main Methods:

  • Retrospective review of pediatric patients diagnosed with IC between 2010 and 2022.
  • Analysis of demographics, family history, laboratory markers, serology, and clinical features at diagnosis.
  • Colonoscopic findings and long-term follow-up data were collected.

Main Results:

  • Of 185 pediatric IBD cases, 29 (15.7%) were classified as IC.
  • Over a quarter of patients (25%) had concomitant autoimmune diseases, predominantly in females.
  • Pancolonic involvement occurred in 48% at diagnosis, with 13.7% developing extraintestinal manifestations.
  • Genetic variants in IBD-related genes were found in 20.6% of patients.
  • Two patients were later reclassified as ulcerative colitis (UC) or Crohn's disease (CD).

Conclusions:

  • Genetic evaluation is recommended for pediatric IC, especially in those with co-occurring autoimmune conditions.
  • Close monitoring is essential for managing potential immune-related complications and treatment success.
  • Further research is needed to fully elucidate the disease course and optimize care for pediatric IC.
Abstract

Keywords:
Indeterminate colitisInflammatory bowel diseasePediatric

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