THE ROLE OF PEYERS-PATCHES IN THE AGE-RELATED INCIDENCE OF CROHNS-DISEASE

Recently researchers have suggested that clinical subsets of Crohn's d isease occur, which are variously described as inflammatory, fibrosten otic, and fistulizin. In addition, it has been observed that within fa milies with multiple cases, often there is concordance of the site and type of disease. The lesions of Crohn's disease occur in segments tha t suggest the distribution of Peyer's patches. When the age-related in cidence of Crohn's disease was plotted for all countries from which su ch data were available. the peaks of greatest case frequency occurred at ages 15 to 25 years and paralleled a similar peak representing the number of Peyer's patches as a function of age. This correlation sugge sts that Crohn's disease may develop as an inflammatory process specif ically targeting these important lymphoid structures. Similar peaks of activity in the adolescent to early adult years occur for appendiciti s and tonsillitis.