Clinical significance of the noninvasive mucosal inflammation index for assessing the endoscopic activity of Crohn’s disease in children

Abstract

Introduction. The use of non-invasive methods for examining patients with endoscopic remission can be useful in identifying the need for endoscopic interventions and assessing disease activity over time. Materials and methods. We analyzed two hundred thirty two medical histories of children with Crohn’s disease (CD) who were examined and treated at the National Medical Research Center for Children’s Health. The relationship between the CD simple endoscopic score (SES-CD) and the newly developed mucosal inflammation noninvasive index (MINI) was determined. Similarly, data from 80 children with ulcerative colitis were examined to identify correlations between the ulcerative colitis endoscopic index of severity (UCEIS) and MINI. Results. Among all forms of Crohn’s disease, a direct strong correlation was found between MINI and SES-CD (R = 0.81, p < 0.001). A MINI value > 5 indicated the absence of mucosal healing (SES-CD > 2 points) with a sensitivity of 73% and a specificity of 84%, and a MINI value ≥13 predicted high activity of Crohn’s disease (SES-CD ≥ 16 points) with sensitivity and specificity of 79% and 88%, respectively. The correlation between MINI and UCEIS in patients with ulcerative colitis revealed an average relationship, which requires further modification of the index in accordance with the characteristics of the course of the disease. Conclusion. The newly developed MINI is a simple and intuitive tool for assessing mucosal inflammation in CD children.