ESPGHAN Revised Porto Criteria for the Diagnosis of Inflammatory Bowel Disease in Children and Adolescents

Abstract

Background: The diagnosis of pediatric-onset inflammatory bowel disease (PIBD) can be challenging in choosing the most informative diagnostic tests and correctly classifying PIBD into its different subtypes. Recent advances in our understanding of the natural history and phenotype of PIBD, increasing availability of serological and fecal biomarkers, and the emergence of novel endoscopic and imaging technologies taken together have made the previous Porto criteria for the diagnosis of PIBD obsolete. Methods: We aimed to revise the original Porto criteria using an evidencebased approach and consensus process to yield specific practice recommendations for the diagnosis of PIBD. These revised criteria are based on the Paris classification of PIBD and the original Porto criteria while

Inflammatory Bowel Disease in Childhood and Adolescence

“…findings (including fecal inflammatory markers). It is diagnosed if there are abnormal findings in clinical history and on physical examination using endoscopy and radiology, including histopathological evaluation of stepwise biopsies from the upper and lower gastrointestinal tract (16).…”

“…Involvement of the small intestine is assessed using either magnetic resonance (MR) enterography with oral contrast only (administered per os or via nasogastric tube) or video capsule endoscopy (16). MR enterography can be performed from the age of 3 or 4 years.…”

Histopathological features of gastrointestinal mucosal biopsies in children with juvenile idiopathic arthritis

“…The detection of an underlying IBD revealed to be crucial in order to establish the correct treatment option that led to clinical improvement (25). If histopathology might be indecisive and IBD could not be excluded, it might be reasonable in these children to perform further assessment following including imaging and mid gut assessment (26). Therefore, it might be of great importance that pediatric rheumatologists and gastroenterologists work close together.…”

“…Histological features as per standard histopathology reporting practice for GI mucosal biopsies (26) were recorded and compared with the clinical information. For the purposes of this article, there were additionally four categories of GI biopsy finding: (i) normal, (ii) mild nonspecific inflammation-increased lamina propria inflammatory cells density but no neutrophilic infiltration, (iii) active inflammationneutrophilic crypt or surface epithelial infiltration, (iv) prominent eosinophils.…”

Management of Crohn's Disease

“…10 CD often has an insidious onset, which may contribute to considerable diagnostic delay. CD can affect the entire intestinal tract, and transmural inflammation can lead to stricture formation and fistulisation between the gut and other abdominal organs as well as the skin.…”