NOD2 and Cowden disease: Beyond disease location and behavior at diagnosis (e.g., penetrating disease, perianal disease), previous attempts to include complex biomarkers in personalizing CD therapy, have not been widely adopted in pediatric CD, for example, NOD2/CARD15 genetics, anti-microbial serology.83 According to the Beaugerie criteria, pediatric age at diagnosis alone is associated with worse disease course.84 Atia et al.85, –87 have illustrated the lack of reliable biomarkers of severity in pediatric CD with available rarely RCTs able to reflect the breadth of phenotypes of the patient population in CD.