Predicting pediatric IBD years before diagnosis using routine blood tests

Raffi Lev-Zion, Amir Shlomo Dolev, Shira Greenfeld, Revital Kariv, Natan Ledderman, Eran Matz, Iris Dotan, Uri Kopylov, Dan Turner, Boaz Lerner

Research output: Chapter in Book/Report/Conference proceedingConference contributionpeer-review


Recent studies such as the GEM project have identified microbial, serological and metabolomic markers that may help predict inflammatory bowel disease (IBD) well in advance of diagnosis, with the ultimate goal of pre-disease prevention. In this population-based study, we used the epi-Israeli IBD Research Nucleus (IIRN) validated cohort to explore the utility of routine blood tests as markers for pre-diagnostic IBD prediction in the pediatric population.
We included all blood tests from all IBD patients diagnosed from 2005-2020 in three of the four Israeli health maintenance organizations (HMOs), and individually matched each to two non-IBD controls. Means were compared using Welch's t-test with false discovery rate correction to account for multiple comparisons. Trends over time were analyzed to detect tests that showed divergence between cases and controls ≥1 year before diagnosis.
Pre-diagnosis results from 228 different blood tests were collected for 7,041 Crohn’s disease (CD) patients and 5,590 ulcerative colitis (UC) patients, including 1,352 children with CD and 666 children with UC (mean age 13.4±3.2 years for CD and 12.9 ± 3.8 years for UC). Median pre-diagnosis data collection duration was 42 (IQR 12-71) months for CD and 41 (IQR 11-70) months for UC. Eleven tests (4.8%) showed significant differences between CD and controls ≥ 1 year before diagnosis (Figure 1); hemoglobin and MCH already diverged at 29 and 26 months, respectively, before diagnosis. In UC patients, no tests showed statistically significant differences ≥1 year pre-diagnosis.
We were able to detect changes in routine blood tests long before diagnosis of pediatric CD, opening the possibility of detecting early signals of future CD diagnosis in children undergoing routine blood tests. These may be used for developing prediction models for prevention strategies.
Original languageAmerican English
Title of host publicationESPGHAN Congress in Vienna
StateAccepted/In press - 2023


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