P670 Familial Inflammatory Bowel Disease is associated with a more adverse disease compared to sporadic cases
Boaz, E.(1);Ariella, B.G.S.(2);Menachem, S.(2);Eran, G.(2);Petachia, R.(1);Shlomo, Y.(1);Koslowsky, B.(2);
(1)Shaare Zedek Medical Center, Department of Surgery, Jerusalem, Israel;(2)Shaare Zedek Medical Center, Department of Gastroenterology, Jerusalem, Israel;
Background
A family history increases the risk for inflammatory bowel diseases (IBD). However, data on differences in phenotypic characteristics and severity among patients with a strong family history of IBD are both scarce and controversial. The aim of the present study was to compare the phenotypic features of IBD patients with 4 or more affected first-degree relatives with sporadic cases of IBD.
Methods
Patients with familial and sporadic IBD were identified from the institutional IBD database. IBD Patients with at least 4 first-degree affected relatives were selected for analysis and were compared to non-matched sporadic cases with IBD chosen randomly from our local database. The sporadic cases had a first and second degree negative family history of IBD. Comparison for type of IBD [Crohn’s disease (CD) vs. ulcerative colitis (UC)], age at onset as well as for disease extent, behavior, perianal disease, extraintestinal manifestations (EIM), and indicators of severe disease (i.e., need for biological agents and surgery) were analyzed.
Results
Thirty six patients with familial IBD (29 Crohn's disease (CD), 7 ulcerative colitis (UC)) were compared to 88 sporadic IBD patients (61 CD, 24 UC, 3 IBD-unclassified). Disease duration was 10.1 ± 8.3 in the familial and 8.1 ± 7.3 years in the sporadic cases, p=0.18. The familial cases were younger at diagnosis (19.1± 8.6 vs. 25.7 ± 11.8, P < 0.003). Patients with familial compared to sporadic IBD were significantly more likely to require steroid treatment (84.8% vs. 54.5%, P < 0.002) biological treatment (91.6%, vs. 63.6%, P < 0.002) or surgery (25%, vs. 11.4%, P = 0.056), respectively.
Conclusion
IBD with a very strong positive family history is associated with younger age at onset and a more adverse IBD phenotype compared to sporadic IBD.