Development of the Crohn's disease digestive damage score, the Lémann score

Benjamin Pariente, Jacques Cosnes, Silvio Danese, William J. Sandborn, Maãté Lewin, Joel G. Fletcher, Yehuda Chowers, Geert D'Haens, Brian G. Feagan, Toshifumi Hibi, Daniel W. Hommes, E. Jan Irvine, Michael A. Kamm, Edward V. Loftus, Edouard Louis, Pierre Michetti, Pia Munkholm, Tom Oresland, Julian Panés, Laurent Peyrin-BirouletWalter Reinisch, Bruce E. Sands, Juergen Schoelmerich, Stefan Schreiber, Herbert Tilg, Simon Travis, Gert Van Assche, Maurizio Vecchi, Jean Yves Mary, Jean Frédéric Colombel, Marc Lémann

Research output: Contribution to journalReview articlepeer-review

481 Scopus citations


Crohn's disease (CD) is a chronic progressive destructive disease. Currently available instruments measure disease activity at a specific point in time. An instrument to measure cumulative structural damage to the bowel, which may predict long-term disability, is needed. The aim of this article is to outline the methods to develop an instrument that can measure cumulative bowel damage. The project is being conducted by the International Program to develop New Indexes in Crohn's disease (IPNIC) group. This instrument, called the Crohn's Disease Digestive Damage Score (the Lémann score), should take into account damage location, severity, extent, progression, and reversibility, as measured by diagnostic imaging modalities and the history of surgical resection. It should not be "diagnostic modality driven": for each lesion and location, a modality appropriate for the anatomic site (for example: computed tomography or magnetic resonance imaging enterography, and colonoscopy) will be used. A total of 24 centers from 15 countries will be involved in a cross-sectional study, which will include up to 240 patients with stratification according to disease location and duration. At least 120 additional patients will be included in the study to validate the score. The Lémann score is expected to be able to portray a patient's disease course on a double-axis graph, with time as the x-axis, bowel damage severity as the y-axis, and the slope of the line connecting data points as a measure of disease progression. This instrument could be used to assess the effect of various medical therapies on the progression of bowel damage.

Original languageEnglish
Pages (from-to)1415-1422
Number of pages8
JournalInflammatory Bowel Diseases
Issue number6
StatePublished - Jun 2011
Externally publishedYes


  • Crohn's disease
  • illness index severity
  • magnetic resonance imaging


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