Platelet Count at Diagnosis Is Associated with Endoscopic Activity in Pediatric Patients with Crohn's Disease.

Abstract

Purpose: We aimed to evaluate the association between platelet count and endoscopy activity in pediatric patients with Crohn's disease (CD).

Methods: This single center retrospective study included children and adolescents aged <19 years who were newly diagnosed with CD. Comparison of baseline characteristics at diagnosis between two groups divided according to the presence and absence of thrombocytosis were conducted. Factors associated with moderate-to-severe endoscopic activity was also conducted.

Results: A total of 50 were included. Thirty-five patients (70.0%) were male, and the mean age±standard deviation was 13.7±2.5 years. Among patients without thrombocytosis, endoscopic activity was mild in 9 patients (42.9%), moderate in 11 (52.4%), and severe in 1 (4.8%), while among patients with thrombocytosis, endoscopic activity was mild in 3 (10.3%), moderate in14 (48.3%), and severe in 12 (41.4%) (p=0.003). According to multivariate analysis with stepwise selection, platelet count (odds ratio [OR], 1.01; 95% confidence interval [CI], 1.00-1.02; p=0.021) and albumin (OR, 0.15; 95% CI, 0.02-0.98; p=0.045) were significantly associated with moderate-to-severe endoscopic activity at diagnosis. According to the receiver operating characteristic (ROC) curve analysis, the optimal platelet count cut-off level associated with moderate-to-severe endoscopic activity was 456,000/µL with an area under the ROC curve of 0.752 (95% CI, 0.598-0.906; sensitivity, 55.3%; specificity, 91.7%; postitive predictive value, 95.5%; negative predictive value, 39.3%; p<0.001).

Conclusion: Pediatric patients with CD that present with thrombocytosis at diagnosis are likely to have a moderate-to-severe endoscopic activity.