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Pediatric Ulcerative Colitis Activity Index (PUCAI)

Clinical severity index for ulcerative colitis in children.

Pediatric Ulcerative Colitis Activity Index (PUCAI)
Abdominal pain
Rectal bleeding
Stool consistency of most stools
Number of stools per 24 hours
Nocturnal stools (any episode waking the child)
Activity level
Result0 points

Remission (PUCAI range 0-85).

Category
Remission

When to use

  • Grading disease activity and monitoring treatment response in children with ulcerative colitis, without requiring endoscopy.

Formula

Sum of 6 weighted items (abdominal pain, rectal bleeding, stool consistency, stools/24h, nocturnal stools, activity limitation). Range 0-85: <10 remission, 10-34 mild, 35-64 moderate, 65-85 severe.

Pearls and pitfalls

  • A PUCAI ≥65 at day 3 of intravenous steroids for acute severe colitis predicts a high likelihood of needing second-line (rescue) therapy.

References

  1. Turner D, et al. Gastroenterology. 2007;133(2):423-32.