Prevalence of inflammatory bowel disease among pediatric patients with hidradenitis suppurativa and the potential role of screening with fecal calprotectin

Background/Objectives Previous studies have demonstrated an increased prevalence of inflammatory bowel disease (IBD) in adults with hidradenitis suppurativa (HS). Whether the same association exists in pediatric patients is unknown. Fecal calprotectin (FC) is used to screen and monitor disease activity in IBD. There are no data on using FC to screen for IBD in pediatric patients with HS. Study objectives include a) assessing the prevalence of IBD among pediatric patients with HS; b) characterizing the IBD phenotype among pediatric patients with HS; and c) describing the use of FC as a screening tool for IBD in this population. Design/Methods This retrospective chart review was conducted at a single academic children's hospital. We included patients <= 18 years old diagnosed with HS between 2013 and 2018. Results We identified 109 pediatric patients with HS. Six patients (6/109, 5.5%) were diagnosed with IBD, 83.3% (5/6) classified as ulcerative colitis. Almost half (53/109, 48.6%) of HS patients had gastrointestinal symptoms; of those, 11.3% (6/53) were diagnosed with IBD. FC was obtained in 8.3% (9/109) of HS patients overall and 66.7% (4/6) of HS patients diagnosed with IBD. Among patients with gastrointestinal symptoms, FC was obtained in 17.0% (9/53); endoscopy was performed in 24.5% (13/53). FC was elevated in all patients with IBD with an FC level. Of those with elevated FC, 80.0% (4/5) had IBD. Conclusions Pediatric HS may be associated with an increased prevalence of IBD suggesting that more widespread screening for IBD may be indicated. FC is infrequently used but may be a useful screening tool.