Clinical usefulness of the Mucosal Inflammation Noninvasive Index in newly diagnosed paediatric Crohn's disease patients

Introduction: Mucosal healing (MH) has become a therapeutic goal in Crohn's Disease (CD), but its frequent evaluation in endoscopic examination is fraught with several limitations. There is an increasing demand to replace invasive procedures with noninvasive markers of CD.

Aim: To assess the clinical importance of the recently developed Mucosal Inflammation Noninvasive Index (MINI) in newly diagnosed paediatric Crohn's Disease patients.

Material and methods: Out of 60 consecutive newly diagnosed paediatric CD patients, 55 were enrolled in the study. The study examined the relationship between Simple Endoscopic Score for CD (SES-CD), Paediatric Crohn's Disease Activity Index (PCDAI), laboratory findings and the newly developed MINI index.

Results: Out of the 55 paediatric patients involved in the study, ileocolonoscopy was successful in 42 patients. In this group there was a strong positive correlation between MINI and PCDAI (R = 0.61; p < 0.001) and a moderate positive correlation between MINI and SES-CD (R = 0.39; p = 0.011). MINI score of 17 points or more indicated severe CD (defined as SES-CD ≥ 16 points) with a diagnostic sensitivity of 90% but with a low specificity of 50%. There were 13 (23%) patients in whom ileocecal valve intubation was not achieved, and in this group the correlation between MINI and PCDAI was also strong (R = 0.66; p = 0.014).

Conclusions: The newly developed MINI index is a simple and intuitive clinimetric score that can be considered a useful tool in assessing mucosal inflammation among newly diagnosed paediatric CD patients.