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<h4>Background</h4>It is important to identify patients with monogenic IBD since management may differ from classical IBD. In this position statement we formulate recommendations for the use of genomics in evaluating potential monogenic causes of IBD across age groups.<h4>Methods</h4>The consensus included paediatric IBD specialists from the Paediatric IBD Porto group of the European Society of Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) and specialists from several monogenic IBD research consortia. We defined key topics and performed a systematic literature review to cover indications, technologies (targeted panel, exome and genome sequencing), gene panel setup, cost-effectiveness of genetic screening, and requirements for the clinical care setting. We developed recommendations that were voted upon by all authors and Porto group members (32 voting specialists).<h4>Results</h4>We recommend next-generation DNA sequencing technologies to diagnose monogenic causes of IBD in routine clinical practice embedded in a setting of multidisciplinary patient care. Routine genetic screening is not recommended for all IBD patients. Genetic testing should be considered depending on age of IBD onset (infantile IBD, very early onset IBD, paediatric or young adult IBD) and further criteria such as family history, relevant comorbidities and extraintestinal manifestations. Genetic testing is also recommended in advance of hematopoietic stem cell transplantation. We develop a diagnostic algorithm that includes a gene panel of seventy-five monogenic IBD genes. Considerations are provided also for low resource countries.<h4>Summary</h4>Genomic technologies should be considered an integral part of patient care to investigate patients at risk for monogenic forms of IBD.

Original publication

DOI

10.1097/mpg.0000000000003017

Type

Journal article

Journal

Journal of pediatric gastroenterology and nutrition

Publication Date

16/12/2020

Volume

Publish Ahead of Print

Addresses

Translational Gastroenterology Unit, University of Oxford, Oxford, UK Department of Pediatrics, University of Oxford, Oxford, United Kingdom Biomedical Research Center, University of Oxford, Oxford, United Kingdom Université de Paris, INSERM UMR 1163 Immunité Intestinale, APHP, Hôpital Necker Enfants Malades, Service de Génétique moléculaire, Paris, France Department of Pediatrics, Dr. von Hauner Children's Hospital, University Hospital, LMU Munich, Munich, Germany Pediatric Gastroenterology Unit, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Ramat Gan, Israel and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel Paediatric Gastroenterology, University Federico II, Naples, Italy Department of Paediatric Gastroenterology, Erasmus University Medical Center Sophia Children's Hospital, 3015 GD Rotterdam, The Netherlands Amsterdam University Medical Centres, Emma Children's Hospital, 1105 AZ Amsterdam, The Netherlands and Tytgat Institute for Liver and Intestinal Research, Amsterdam Gastroenterology and Metabolism, Academic Medical Centre, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands Division of Gastroenterology, Hepatology, and Nutrition, Boston Children's Hospital and Harvard Medical School, Boston, MA 02115, USA Université de Paris, APHP, Hôpital Necker Enfants Malades, Service de Gastroentérologie pédiatrique, Paris, France Child Life and Health, University of Edinburgh; Department of Paediatric Gastroenterology, The Royal Hospital for Sick Children, Edinburgh The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada SickKids Inflammatory Bowel Disease Centre and Cell Biology Program, Research Institute, The Hospital for Sick Children, Toronto, Canada Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Toronto, Canada Shaare Zedek Medical Center, The Hebrew University of Jerusalem, Israel.

Keywords

Paediatric IBD Porto group of ESPGHAN