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Disease severity and treatment requirements in familial inflammatory bowel disease
- Source :
- International journal of colorectal disease. 32(8)
- Publication Year :
- 2017
-
Abstract
- Several studies demonstrate an increased prevalence and concordance of inflammatory bowel disease among the relatives of patients. Other studies suggest that genetic influence is over-estimated. The aims of this study are to evaluate the phenotypic expression and the treatment requirements in familial inflammatory bowel disease, to study the relationship between number of relatives and degree of kinship with disease severity and to quantify the impact of family aggregation compared to other environmental factors. Observational analytical study of 1211 patients followed in our unit. We analyzed, according to the existence of familial association, number and degree of consanguinity, the phenotypic expression, complications, extraintestinal manifestations, treatment requirements, and mortality. A multivariable analysis considering smoking habits and non-steroidal-anti-inflammatory drugs was performed. 14.2% of patients had relatives affected. Median age at diagnosis tended to be lower in the familial group, 32 vs 29, p = 0.07. In familial ulcerative colitis, there was a higher proportion of extraintestinal manifestations: peripheral arthropathy (OR = 2.3, p = 0.015) and erythema nodosum (OR = 7.6, p = 0.001). In familial Crohn’s disease, there were higher treatment requirements: immunomodulators (OR = 1.8, p = 0.029); biologics (OR = 1.9, p = 0.011); and surgery (OR = 1.7, p = 0.044). The abdominal abscess increased with the number of relatives affected: 5.1% (sporadic), 7.0% (one), and 14.3% (two or more), p=0.039. These associations were maintained in the multivariate analysis. Familial aggregation is considered a risk factor for more aggressive disease and higher treatment requirements, a tendency for earlier onset, more abdominal abscess, and extraintestinal manifestations, remaining a risk factor analyzing the influence of some environmental factors.
- Subjects :
- Adult
Male
medicine.medical_specialty
Disease
Inflammatory bowel disease
Severity of Illness Index
03 medical and health sciences
Young Adult
0302 clinical medicine
Crohn Disease
Internal medicine
Arthropathy
medicine
Humans
Family
030212 general & internal medicine
Risk factor
Erythema nodosum
business.industry
Anti-Inflammatory Agents, Non-Steroidal
Smoking
Gastroenterology
Family aggregation
Hepatology
medicine.disease
Inflammatory Bowel Diseases
Ulcerative colitis
Immunology
Multivariate Analysis
030211 gastroenterology & hepatology
Colitis, Ulcerative
Female
business
Subjects
Details
- ISSN :
- 14321262
- Volume :
- 32
- Issue :
- 8
- Database :
- OpenAIRE
- Journal :
- International journal of colorectal disease
- Accession number :
- edsair.doi.dedup.....e777c625942b9b1d5aa9089c3b339c5a