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


Por: Levine A, Koletzko S, Turner D, Escher JC, Cucchiara S, de Ridder L, Kolho KL, Veres G, Russell RK, Paerregaard A, Buderus S, Greer ML, Dias JA, Veereman-Wauters G, Lionetti P, Sladek M, Martín-de-Carpi J, Staiano A, Ruemmele FM and Wilson DC

Publicada: 1 jun 2014
Resumen:
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 evidence-based 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 incorporating novel data, such as for serum and fecal biomarkers. A consensus of at least 80% of participants was achieved for all recommendations and the summary algorithm.Results:The revised criteria depart from existing criteria by defining 2 categories of ulcerative colitis (UC, typical and atypical); atypical phenotypes of UC should be treated as UC. A novel approach based on multiple criteria for diagnosing IBD-unclassified (IBD-U) is proposed. Specifically, these revised criteria recommend upper gastrointestinal endoscopy and ileocolonscopy for all suspected patients with PIBD, with small bowel imaging (unless typical UC after endoscopy and histology) by magnetic resonance enterography or wireless capsule endoscopy.Conclusions:These revised Porto criteria for the diagnosis of PIBD have been developed to meet present challenges and developments in PIBD and provide up-to-date guidelines for the definition and diagnosis of the IBD spectrum.

Filiaciones:
Levine A:
 *Pediatric Gastroenterology and Nutrition Unit, Wolfson Medical Center, Sackler School of Medicine, Tel Aviv University, Israel †Dr. v. Hauner Children's Hospital, Ludwig Maximilians University, Munich, Germany ‡Pediatric Gastroenterology Unit, Shaare Zed

Koletzko S:
 *Pediatric Gastroenterology and Nutrition Unit, Wolfson Medical Center, Sackler School of Medicine, Tel Aviv University, Israel †Dr. v. Hauner Children's Hospital, Ludwig Maximilians University, Munich, Germany ‡Pediatric Gastroenterology Unit, Shaare Zed

Turner D:
 *Pediatric Gastroenterology and Nutrition Unit, Wolfson Medical Center, Sackler School of Medicine, Tel Aviv University, Israel †Dr. v. Hauner Children's Hospital, Ludwig Maximilians University, Munich, Germany ‡Pediatric Gastroenterology Unit, Shaare Zed

Escher JC:
 *Pediatric Gastroenterology and Nutrition Unit, Wolfson Medical Center, Sackler School of Medicine, Tel Aviv University, Israel †Dr. v. Hauner Children's Hospital, Ludwig Maximilians University, Munich, Germany ‡Pediatric Gastroenterology Unit, Shaare Zed

Cucchiara S:
 *Pediatric Gastroenterology and Nutrition Unit, Wolfson Medical Center, Sackler School of Medicine, Tel Aviv University, Israel †Dr. v. Hauner Children's Hospital, Ludwig Maximilians University, Munich, Germany ‡Pediatric Gastroenterology Unit, Shaare Zed

de Ridder L:
 *Pediatric Gastroenterology and Nutrition Unit, Wolfson Medical Center, Sackler School of Medicine, Tel Aviv University, Israel †Dr. v. Hauner Children's Hospital, Ludwig Maximilians University, Munich, Germany ‡Pediatric Gastroenterology Unit, Shaare Zed

Kolho KL:
 *Pediatric Gastroenterology and Nutrition Unit, Wolfson Medical Center, Sackler School of Medicine, Tel Aviv University, Israel †Dr. v. Hauner Children's Hospital, Ludwig Maximilians University, Munich, Germany ‡Pediatric Gastroenterology Unit, Shaare Zed

Veres G:
 *Pediatric Gastroenterology and Nutrition Unit, Wolfson Medical Center, Sackler School of Medicine, Tel Aviv University, Israel †Dr. v. Hauner Children's Hospital, Ludwig Maximilians University, Munich, Germany ‡Pediatric Gastroenterology Unit, Shaare Zed

Russell RK:
 *Pediatric Gastroenterology and Nutrition Unit, Wolfson Medical Center, Sackler School of Medicine, Tel Aviv University, Israel †Dr. v. Hauner Children's Hospital, Ludwig Maximilians University, Munich, Germany ‡Pediatric Gastroenterology Unit, Shaare Zed

Paerregaard A:
 *Pediatric Gastroenterology and Nutrition Unit, Wolfson Medical Center, Sackler School of Medicine, Tel Aviv University, Israel †Dr. v. Hauner Children's Hospital, Ludwig Maximilians University, Munich, Germany ‡Pediatric Gastroenterology Unit, Shaare Zed

Buderus S:
 *Pediatric Gastroenterology and Nutrition Unit, Wolfson Medical Center, Sackler School of Medicine, Tel Aviv University, Israel †Dr. v. Hauner Children's Hospital, Ludwig Maximilians University, Munich, Germany ‡Pediatric Gastroenterology Unit, Shaare Zed

Greer ML:
 *Pediatric Gastroenterology and Nutrition Unit, Wolfson Medical Center, Sackler School of Medicine, Tel Aviv University, Israel †Dr. v. Hauner Children's Hospital, Ludwig Maximilians University, Munich, Germany ‡Pediatric Gastroenterology Unit, Shaare Zed

Dias JA:
 *Pediatric Gastroenterology and Nutrition Unit, Wolfson Medical Center, Sackler School of Medicine, Tel Aviv University, Israel †Dr. v. Hauner Children's Hospital, Ludwig Maximilians University, Munich, Germany ‡Pediatric Gastroenterology Unit, Shaare Zed

Veereman-Wauters G:
 *Pediatric Gastroenterology and Nutrition Unit, Wolfson Medical Center, Sackler School of Medicine, Tel Aviv University, Israel †Dr. v. Hauner Children's Hospital, Ludwig Maximilians University, Munich, Germany ‡Pediatric Gastroenterology Unit, Shaare Zed

Lionetti P:
 *Pediatric Gastroenterology and Nutrition Unit, Wolfson Medical Center, Sackler School of Medicine, Tel Aviv University, Israel †Dr. v. Hauner Children's Hospital, Ludwig Maximilians University, Munich, Germany ‡Pediatric Gastroenterology Unit, Shaare Zed

Sladek M:
 *Pediatric Gastroenterology and Nutrition Unit, Wolfson Medical Center, Sackler School of Medicine, Tel Aviv University, Israel †Dr. v. Hauner Children's Hospital, Ludwig Maximilians University, Munich, Germany ‡Pediatric Gastroenterology Unit, Shaare Zed

Martín-de-Carpi J:
 *Pediatric Gastroenterology and Nutrition Unit, Wolfson Medical Center, Sackler School of Medicine, Tel Aviv University, Israel †Dr. v. Hauner Children's Hospital, Ludwig Maximilians University, Munich, Germany ‡Pediatric Gastroenterology Unit, Shaare Zed

Staiano A:
 *Pediatric Gastroenterology and Nutrition Unit, Wolfson Medical Center, Sackler School of Medicine, Tel Aviv University, Israel †Dr. v. Hauner Children's Hospital, Ludwig Maximilians University, Munich, Germany ‡Pediatric Gastroenterology Unit, Shaare Zed

Ruemmele FM:
 *Pediatric Gastroenterology and Nutrition Unit, Wolfson Medical Center, Sackler School of Medicine, Tel Aviv University, Israel †Dr. v. Hauner Children's Hospital, Ludwig Maximilians University, Munich, Germany ‡Pediatric Gastroenterology Unit, Shaare Zed

Wilson DC:
 *Pediatric Gastroenterology and Nutrition Unit, Wolfson Medical Center, Sackler School of Medicine, Tel Aviv University, Israel †Dr. v. Hauner Children's Hospital, Ludwig Maximilians University, Munich, Germany ‡Pediatric Gastroenterology Unit, Shaare Zed
ISSN: 02772116





JOURNAL OF PEDIATRIC GASTROENTEROLOGY AND NUTRITION
Editorial
WILEY, 111 RIVER ST, HOBOKEN 07030-5774, NJ, Estados Unidos America
Tipo de documento: Article
Volumen: 58 Número: 6
Páginas: 795-806
WOS Id: 000336261600030
ID de PubMed: 24231644
imagen Green Published, Bronze

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