Pediatric Crohn's Disease Activity Index (PCDAI) Medical Algorithms

Description

Hyams et al developed a pediatric Crohn's disease activity index (PCDAI). This can be used to monitor the disease over time and the response to therapy. The authors are from multiple hospitals in the United States.

Parameters:

(1) abdominal pain during the past week

(2) stools per day

(3) general well-being and functioning during the past week

(4) hematocrit

(5) erythrocyte sedimentation rate (ESR)

(6) serum albumin

(7) body weight

(8) height at diagnosis OR follow-up height velocity (based on the data of Tanner et al)

(9) abdomen examination

(10) perirectal disease

(11) extra-intestinal manifestations (fever, arthritis, uveitis, erythema nodosum, pyogenic gangrenosum)

Parameter	Finding	Points
abdominal pain	none	0
	mild	5
	moderate to severe	10
stools per day	0 to 1 liquid stools without blood	0
	0 to 2 semi-formed stools with a small amount of blood	5
	2 to 5 liquid stools per day	5
	gross bleeding	10
	>= 6 liquid stools per day	10
	nocturnal diarrhea	10
general well-being	no limitations, well	0
	occasional difficulty, below par	5
	frequent limitations, very poor	10
hematocrit in percent	< 10 years and HCT 28 to 32	0
	< 10 years and HCT >= 33	2.5
	< 10 years and HCT < 28	5
	11-19, female, HCT < 29	0
	11-19, female, HCT 29 to 33	2.5
	11-19, female, HCT >= 34	5
	11-14, male, HCT < 30	0
	11-14, male, HCT 30 to 34	2.5
	11-14, male, HCT >= 35	5
	15-19, male, HCT < 32	0
	15-19, male, HCT 32 to 36	2.5
	15-19, male, HCT >= 37	5
ESR	< 20 mm in first hour	0
	20 to 50 mm/h	2.5
	> 50 mm/h	5
serum albumin	<= 3.0	0
	3.1 to 3.4 g/dL	5
	>= 3.5 g/dL	10
weight	weight gain	0
	stable	0
	involuntary weight loss 1-9%	5
	involuntary weight loss >= 10%	10
height velocity (Z score)	<= -2.00	10
	-1.99 to -1.01	5
	>= -1.00	0
abdominal pain	no tenderness, no mass	0
	tenderness	5
	mass without tenderness	5
	tenderness, definite mass and/or involuntary guarding	10
perirectal disease	none or asymptomatic tags	0
	1 to 2 indolent fistulas; scant drainage; no tenderness	5
	active fistula, drainage, abscess OR tenderness	10
extra-intestinal manifestations (out of 5)	none	0
	1	5
	2 or more	10

total score =

= SUM(points for all of the parameters)

Interpretation:

• minimum score: 0

• maximum score: 110

• The higher the score the more active the disease.

Total Score	Disease Activity
0 to 10	none
11 to 30	mild
>= 31	moderate or severe

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Description

Specialty

Objective

ICD-10

Pediatric Crohn's Disease Activity Index (PCDAI) of Hyams et al

Purpose: To evaluate a pediatric patient with Crohn's disease using the disease activity index (PCDAI) of Hyams et al.

Description

Specialty

Objective

ICD-10