| Sumario: | Background: Pediatric inflammatory bowel disease (PIBD) subtypes are classified according to the PIBD‐classes criteria, comprising 23 items. These criteria were later simplified to 19 diagnostic items. Inflammatory bowel diseases (IBDs) are classified as ulcerative colitis (UC), atypical UC, IBD‐unclassified (IBD‐U), Crohn's disease (CD), or isolated colonic CD. This study aimed to validate the simplified PIBD‐classes criteria in an Asian population and evaluate IBD‐U characteristics. Methods: Patients diagnosed with PIBD between 2007 and 2022 were retrospectively enrolled. Data regarding PIBD phenotypes, age at diagnosis, endoscopic and pathological findings, and biologics and/or steroid use were collected from medical records. Physician‐assigned diagnoses were compared with simplified PIBD‐classes criteria‐based diagnoses. Differences in the clinical features of patients with IBD‐U and other IBDs classified using the simplified PIBD‐class criteria were also evaluated. Results: Eighty‐six patients were included, of whom 54 (63%) had UC, 21 (24%) had CD, and 11 (13%) had IBD‐U. Using the simplified PIBD‐classes criteria, 48 (56%) patients were diagnosed with UC, 3 (3%) with atypical UC, 22 (26%) with CD, 1 (1%) with isolated colonic CD, and 12 (14%) with IBD‐U. The diagnoses were changed in 10 cases based on the simplified PIBD‐classes criteria. There were no significant differences in age at diagnosis or rates of steroid and biologic use between IBD subtypes. Conclusions: Simplified PIBD‐classes criteria‐based diagnoses matched physician‐assigned diagnoses in almost all cases. This study suggests that the simplified PIBD‐classes criteria are useful at reducing diagnostic variability in multicenter and international PIBD studies.
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