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. 2025 Sep;114(9):2329-2336.
doi: 10.1111/apa.70115. Epub 2025 May 7.

Long-Term Outcome of Paediatric Crohn's Disease Patients With Deep Ulcerations at Diagnosis

Monica S Ronconi  1 , Antoine Neuraz  2 , Elise Payen  1 , Elie Abi Nader  1 , Cécile Lambe  1 , Florence Campeotto  1   3 , Cécile Talbotec  1 , Frank M Ruemmele  1   4 , Bénédicte Pigneur  1   3
Affiliations

Long-Term Outcome of Paediatric Crohn's Disease Patients With Deep Ulcerations at Diagnosis

Monica S Ronconi et al. Acta Paediatr. 2025 Sep.

Abstract

Aim: Presence of deep ulcerations (DU) at diagnosis seems to be predictive of a more severe phenotype in adult Crohn's disease (CD). The aim of our study was to investigate if the presence of DU at diagnosis was associated with a more severe disease course over time in children.

Methods: In this monocentric retrospective study, we analysed data from paediatric patients with a new diagnosis of CD from 2009 to 2017. Clinical, laboratory data, treatments and complications were recorded for each patient at diagnosis and at 1, 3 and 5 years of follow-up. Patients were compared according to the presence or absence of DU on colonoscopy.

Results: Among the 116 patients included in the study, 52 patients had DU at diagnosis. Comparison showed an increased risk for patients with DU to develop abdominal abscesses (p = 0.045) and to experience more relapses (p = 0.013) at 1 year. At 3 and 5 years, there was no longer any difference between groups. The time from diagnosis to first anti-TNF alpha was shorter in DU patients.

Conclusion: The presence of DU at diagnosis is associated with more complications during the first year of follow-up but not after, due to a more active therapeutic management.

Keywords: IBD; children; endoscopy; prognostic factor; ulcerations.

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Conflict of interest statement

F.M.R. has received a consultation fee, research grant or honorarium from Janssen, Pfizer, Abbvie, Takeda, Celgene, Nestlé Health Science and Nestlé Nutrition Institute. B.P. has served as a speaker for Biocodex and Amgen. The other authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Deep ulcerations at colonoscopy.
FIGURE 2
FIGURE 2
Flowchart.
FIGURE 3
FIGURE 3
Time to first anti‐TNF alpha (survival curve, months).
See this image and copyright information in PMC

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Supplementary concepts