Description:
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<jats:title>Background:</jats:title>
<jats:p>Data describing extent change (progression or regression) in pediatric-onset ulcerative colitis (UC) are scarce.</jats:p>
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<jats:title>Goal:</jats:title>
<jats:p>We aimed to describe extent change in pediatric-onset UC during long-term follow-up and to assess predictors of extent change.</jats:p>
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<jats:title>Study:</jats:title>
<jats:p>Medical charts of pediatric-onset UC patients with at least 5-year follow-up were analyzed retrospectively. Disease extent was determined using the Paris classification. It was examined at diagnosis and during follow-up at different time points. The impact of possible predictors on extent change including age at diagnosis, gender, clinical manifestations, disease, severity indices, and different therapeutic regimens during disease course was assessed.</jats:p>
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<jats:title>Results:</jats:title>
<jats:p>Patients (n=134, 55% males) were followed for a median duration of 13.1 (range, 5 to 28) years. Median age at diagnosis was 13.1 (range, 2 to 17.8) years. Of 134 patients, 40.5% had extensive or pancolitis, 33.5% left-sided colitis, and 26% had proctitis at diagnosis. On follow-up (n=117), 45% had unchanged disease extent, 35% experienced extent progression, whereas 20% experienced regression of disease extent. The multivariate Cox models demonstrated that among children with left-sided disease at diagnosis, presence of extraintestinal manifestations (hazard ratio, 5.19; <jats:italic toggle="yes">P</jats:italic>=0.022), and higher pediatric UC activity index (hazard ratio, 8.77; <jats:italic toggle="yes">P</jats:italic>=0.008) were associated with extent progression to extensive disease. Predictors of extent regression have not been identified.</jats:p>
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<jats:title>Conclusions:</jats:title>
<jats:p>Disease extent changes significantly over time in pediatric-onset UC. In our cohort, presence of extraintestinal manifestation and higher pediatric UC activity index score at diagnosis were associated with progression from limited to extensive disease during follow-up.</jats:p>
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