Crohn's disease severity in familial and sporadic cases

Background-Having a relative with inflammatory bowel disease increases the risk for Crohn's disease but may also increase its severity in affected pat ients. Aims-To evaluate the influence of a family history on Crohn's disease cours e and severity. Methods-1316 patients followed in the same unit were studied retrospectivel y. Age at onset, duration of illness, site, and extent of disease were dete rmined in patients with and without a family history. Additionally, disease severity was estimated by the need for medical therapy (steroid and immuno suppressive requirement) and the frequency and extent of excisional surgery . Results-152 (12%) patients had a family history of inflammatory bowel disea se. Duration of follow up was longer in patients with a family history and there were more operations for perforating complications in familial cases. However, the importance of medical therapy, and the incidence and extent o f excisional surgery were similar in familial and and sporadic cases. Kapla n-Meier estimated time to prescription of immunosuppressive drugs and first intestinal resection were similar in familial and sporadic cases. When the 152 patients with familial Crohn's disease were paired for sex, location o f disease at onset, date of birth, and date of diagnosis with 152 patients with sporadic Crohn's disease, the disease severity remained similar in the two groups of paired patients. Conclusion-Patients with Crohn's disease and a family history of inflammato ry bowel disease do not have a more severe course.