{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,15]],"date-time":"2026-03-15T20:53:30Z","timestamp":1773608010616,"version":"3.50.1"},"reference-count":38,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2023,7,1]],"date-time":"2023-07-01T00:00:00Z","timestamp":1688169600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,12,30]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>Ulcerative proctitis [UP] is an uncommon presentation in paediatric patients with ulcerative colitis. We aimed to characterize the clinical features and natural history of UP in children, and to identify predictors of poor outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was a retrospective study involving 37 sites affiliated with the IBD Porto Group of ESPGHAN. Data were collected from patients aged &amp;lt;18 years diagnosed with UP between January 1, 2016 and December 31, 2020.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We identified 196 patients with UP (median age at diagnosis 14.6 years [interquartile range, IQR 12.5\u201316.0]), with a median follow-up of 2.7 years [IQR 1.7\u20133.8]. The most common presenting symptoms were bloody stools [95%], abdominal pain [61%] and diarrhoea [47%]. At diagnosis, the median paediatric ulcerative colitis activity index [PUCAI] score was 25 [IQR 20\u201335], but most patients exhibited moderate\u2013severe endoscopic inflammation. By the end of induction, 5-aminosalicylic acid administration orally, topically or both resulted in clinical remission rates of 48%, 48%, and 73%, respectively. The rates of treatment escalation to biologics at 1, 3, and 5 years were 10%, 22%, and 43%, respectively. In multivariate analysis, the PUCAI score at diagnosis was significantly associated with initiation of systemic steroids, or biologics, and subsequent acute severe colitis events and inflammatory bowel disease-associated admission, with a score \u226535 providing an increased risk for poor outcomes. By the end of follow-up, 3.1% of patients underwent colectomy. Patients with UP that experienced proximal disease progression during follow-up [48%] had significantly higher rates of a caecal patch at diagnosis and higher PUCAI score by the end of induction, compared to those without progression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Paediatric patients with UP exhibit high rates of treatment escalation and proximal disease extension.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ecco-jcc\/jjad111","type":"journal-article","created":{"date-parts":[[2023,7,1]],"date-time":"2023-07-01T03:36:53Z","timestamp":1688182613000},"page":"1939-1948","source":"Crossref","is-referenced-by-count":10,"title":["Clinical Features and Natural History of Paediatric Patients with Ulcerative Proctitis: A Multicentre Study from the Paediatric IBD Porto Group of ESPGHAN"],"prefix":"10.1093","volume":"17","author":[{"given":"Noa","family":"Tal","sequence":"first","affiliation":[{"name":"Institute of Gastroenterology, Nutrition and Liver Disease, Schneider Children\u2019s Medical Center , Petah Tikva ,","place":["Israel"]},{"name":"Faculty of Medicine, Tel Aviv University , Tel Aviv ,","place":["Israel"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christos","family":"Tzivinikos","sequence":"additional","affiliation":[{"name":"Paediatric Gastroenterology Department, Al Jalila Children\u2019s Specialty Hospital, Mohammed Bin Rashid University , Dubai ,","place":["United Arab Emirates"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3882-3606","authenticated-orcid":false,"given":"Marco","family":"Gasparetto","sequence":"additional","affiliation":[{"name":"Barts Health NHS Trust, The Royal London Children\u2019s Hospital, Department of Paediatric Gastroenterology, Queen Mary University of London, Centre for Immunobiology, Blizard Institute , London ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0906-1232","authenticated-orcid":false,"given":"Daniela E","family":"Serban","sequence":"additional","affiliation":[{"name":"2nd Clinic of Pediatrics, \u2018Iuliu Hatieganu\u2019 University of Medicine and Pharmacy, Emergency Clinical Hospital for Children , Cluj-Napoca ,","place":["Romania"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eyal","family":"Zifman","sequence":"additional","affiliation":[{"name":"Pediatric Gastroenterology Unit, Meir Medical Center , Kfar-Saba ,","place":["Israel"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Iva","family":"Hojsak","sequence":"additional","affiliation":[{"name":"Referral Center for Pediatric Gastroenterology and Nutrition, Children\u2019s Hospital Zagreb , Zagreb ,","place":["Croatia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8109-814X","authenticated-orcid":false,"given":"Oren","family":"Ledder","sequence":"additional","affiliation":[{"name":"The Juliet Keidan Institute of Pediatric Gastroenterology & Nutrition, Shaare Zedek Medical Center, The Hebrew University of Jerusalem , Jerusalem ,","place":["Israel"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anat","family":"Yerushalmy Feler","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Tel Aviv University , Tel Aviv ,","place":["Israel"]},{"name":"Pediatric Gastroenterology Institute, \u2018Dana-Dwek\u2019 Children\u2019s Hospital, Tel Aviv Sourasky Medical Center , Tel Aviv ,","place":["Israel"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helena","family":"Rolandsdotter","sequence":"additional","affiliation":[{"name":"Department of Clinical Science and Education, S\u00f6dersjukhuset, Karolinska Institutet , Stockholm ,","place":["Sweden"]},{"name":"Sachs\u2019 Children and Youth Hospital, Department of Gastroenterology, S\u00f6dersjukhuset , Stockholm ,","place":["Sweden"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7404-4004","authenticated-orcid":false,"given":"Marina","family":"Aloi","sequence":"additional","affiliation":[{"name":"Pediatric Gastroenterology, Hepatology and Nutrition Institute, Sapienza University of Rome , Rome ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5249-8248","authenticated-orcid":false,"given":"Matteo","family":"Bramuzzo","sequence":"additional","affiliation":[{"name":"Institute for Maternal and Child Health, IRCCS \u2018Burlo Garofolo\u2019 , Trieste 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Barresi\u2019, University of Messina , Messina ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ron","family":"Shaoul","sequence":"additional","affiliation":[{"name":"Pediatric Gastroenterology and Nutrition Institute, Ruth Children\u2019s Hospital of Haifa, Rambam Medical Center, Faculty of Medicine, Technion , Haifa ,","place":["Israel"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christine","family":"Martinez-Vinson","sequence":"additional","affiliation":[{"name":"Service de Gastroent\u00e9rologie et Nutrition P\u00e9diatriques, H\u00f4pital Universitaire Robert-Debr\u00e9 , Paris ,","place":["France"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Karoliny","sequence":"additional","affiliation":[{"name":"Heim P\u00e1l National Pediatric Institute , Budapest ,","place":["Hungary"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elisabeth","family":"De 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,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michal","family":"Kori","sequence":"additional","affiliation":[{"name":"Pdiatric Gastroenterology, Kaplan Medical Centre, Rehovot and the Faculty of Medicine, Hebrew University of Jerusalem , Jerusalem ,","place":["Israel"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marta","family":"Tavares","sequence":"additional","affiliation":[{"name":"Department of Pediatric Gastroenterology, Centro Materno Infantil do Norte, Centro Hospitalar e Universit\u00e1rio de Porto , Porto ,","place":["Portugal"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Batia","family":"Weiss","sequence":"additional","affiliation":[{"name":"Division of Pediatric Gastroenterology and Nutrition, Edmond and Lily Safra Children\u2019s Hospital , Ramat Gan ,","place":["Israel"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9362-0465","authenticated-orcid":false,"given":"Seamus","family":"Hussey","sequence":"additional","affiliation":[{"name":"Children\u2019s Health Ireland, UCD and RCSI , Dublin ,","place":["Ireland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria E","family":"Qamhawi","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hepatology and Nutrition, Astrid Lindgren Children\u2019s Hospital, Karolinska University Hospital , Stockholm \u00a0","place":["Sweden"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura M","family":"Palomino P\u00e9rez","sequence":"additional","affiliation":[{"name":"Gastroenterology and Nutrition Department, Hospital Infantil Universitario Ni\u00f1o Jes\u00fas , Madrid 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