{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T23:34:48Z","timestamp":1777937688279,"version":"3.51.4"},"reference-count":30,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T00:00:00Z","timestamp":1767139200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100008893","name":"university of iowa","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008893","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Pediatr Dev Pathol"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Upper GI involvement is common in pediatric IBD, but the relative frequencies of specific endoscopic and histologic abnormalities at diagnosis remain poorly defined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To determine whether specific upper GI endoscopic and histologic features differ among pediatric Crohn disease (CD), ulcerative colitis (UC), and indeterminate colitis (IC) at diagnosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We retrospectively analyzed 243 pediatric patients (&lt;18\u2009years) with newly diagnosed IBD (CD 64.6%, UC 31.2%, IC 4.1%). Clinical parameters, upper GI endoscopic findings, and histologic features were compared using Fisher\u2019s exact and non-parametric tests.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Age at diagnosis, gender, BMI, and fecal calprotectin did not differ among CD, UC, and IC. Primary sclerosing cholangitis was more prevalent in UC (5.3%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.04), and eosinophilic esophagitis was more frequent in IC (20%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.03). CD showed more esophageal erosions\/aphthae (12%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.01), gastric erosions\/ulcers (24% vs UC 17%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.01), and duodenal erosions\/ulcers (35%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.01). Histologically, lymphocytic esophagitis (29%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.001), epithelioid granulomas (14%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.001), and active duodenitis (28%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.007) were significantly more common in CD.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Upper GI abnormalities are not limited to CD. Specific upper GI features\u2014particularly lymphocytic esophagitis, epithelioid granulomas, and active duodenitis\u2014are more strongly associated with CD at diagnosis and may assist subclassification in challenging pediatric IBD cases.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10935266251404114","type":"journal-article","created":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T10:00:36Z","timestamp":1767175236000},"page":"112-119","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical, Endoscopic, and Upper Gastrointestinal Histological Manifestations in Pediatric Inflammatory Bowel Disease: Insights from a Large Cohort"],"prefix":"10.1177","volume":"29","author":[{"given":"Allen","family":"Choi","sequence":"first","affiliation":[{"name":"Department of Pathology, University of Iowa, Iowa City, IA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eyas","family":"Alzayadneh","sequence":"additional","affiliation":[{"name":"Department of Pathology, University of Iowa, Iowa City, IA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrick","family":"Breheny","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, University of Iowa, Iowa City, IA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4138-5851","authenticated-orcid":false,"given":"Yiqin","family":"Xiong","sequence":"additional","affiliation":[{"name":"Department of Pathology, University of Iowa, Iowa City, IA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,12,31]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.3389\/ijph.2024.1607440"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.gtc.2023.05.001"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.7189\/jogh.13.04174"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.suc.2019.08.008"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.5223\/pghn.2020.23.5.411"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1111\/his.12263"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0b013e31805563f3"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1159\/000501519"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.5223\/pghn.2019.22.1.41"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1111\/jpc.14925"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.32074\/1591-951X-336"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11894-018-0620-2"},{"issue":"3","key":"e_1_3_3_14_2","first-page":"257","article-title":"Diagnostic role of upper gastrointestinal endoscopy in pediatric inflammatory bowel disease","volume":"39","author":"Castellaneta SP","year":"2004","unstructured":"Castellaneta SP, Afzal NA, Greenberg M, et al. Diagnostic role of upper gastrointestinal endoscopy in pediatric inflammatory bowel disease. J Pediatr Gastroenterol Nutr. 2004;39(3):257-261.","journal-title":"J Pediatr Gastroenterol Nutr"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-2007-1021762"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12328-017-0759-7"},{"issue":"3","key":"e_1_3_3_17_2","first-page":"249","article-title":"Duodenal Crohn\u2019s disease: an analysis of 89 cases","volume":"84","author":"Nugent FW","year":"1989","unstructured":"Nugent FW, Roy MA. Duodenal Crohn\u2019s disease: an analysis of 89 cases. Am J Gastroenterol. 1989;84(3):249-254.","journal-title":"Am J Gastroenterol"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-2007-1010315"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1111\/jgh.13992"},{"issue":"2","key":"e_1_3_3_20_2","first-page":"181","article-title":"Prospective evaluation of upper gastrointestinal mucosal lesions in children with ulcerative colitis and Crohn's disease","volume":"19","author":"Ruuska T","year":"1994","unstructured":"Ruuska T, Vaajalahti P, Arajarvi P, Maki M. Prospective evaluation of upper gastrointestinal mucosal lesions in children with ulcerative colitis and Crohn's disease. J Pediatr Gastroenterol Nutr. 1994;19(2):181-186.","journal-title":"J Pediatr Gastroenterol Nutr"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1052-5157(02)00006-5"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1097\/00004836-200401000-00011"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0000000000000239"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0039-1683850"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.path.2020.05.003"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.3109\/00365529708996539"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.4292\/wjgpt.v10.i2.35"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1002\/ibd.21347"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.1309\/7LABLGY08UEM3H26"},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.1053\/gast.1997.v112.pm9041230"},{"key":"e_1_3_3_31_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00535-007-2143-8"}],"container-title":["Pediatric and Developmental Pathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10935266251404114","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/10935266251404114","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10935266251404114","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T04:12:22Z","timestamp":1777695142000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/10935266251404114"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,31]]},"references-count":30,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,3]]}},"alternative-id":["10.1177\/10935266251404114"],"URL":"https:\/\/doi.org\/10.1177\/10935266251404114","relation":{},"ISSN":["1093-5266","1615-5742"],"issn-type":[{"value":"1093-5266","type":"print"},{"value":"1615-5742","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,31]]}}}