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P342. Characteristics of inflammatory bowel disease (IBD) in a cohort of patients of Gypsy ethnicity

J. Echaiz1, I. Marín2, R. Martín-Mateos3, M. Mañosa1,4, V. García5, M. Barreiro6, M. Peñalva7, P. Nos8,4, L.A. Menchen2, A. López-Sanromán3, E. Cabré1,4, E. Domènech1,4

1Hospital Universitari Germans Trias i Pujol, Badalona, Spain; 2Hospital Universitario Gregorio Marañón, Madrid, Spain; 3Hospital Universitario Ramón y Cajal, Madrid, Spain; 4CIBERehd, Barcelona, Spain; 5Hospital Universitario Reina Sofía, Córdoba, Spain; 6Hospital Clínico Universitario, Santiago de Compostela, Santiago de Compostela, Spain; 7Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain; 8Hospital Universitari La Fe, Valencia, Spain

Although some clinical peculiarities in some racial/ethnic non-Caucasian groups (e.g. Asians, Afro-Americans, Hispanics) of IBD patients have been described [1], information on the characteristics of IBD in Gypsies – an ethnic community with a high degree of consanguinity – is lacking.

Aim: To describe the clinical characteristics, therapeutic requirements, and familial aggregation in IBD Gypsy patients.

Material and Methods: All patients of Gypsy ethnicity included in the IBD databases of seven Spanish reference centres were identified. Data on demographics, disease phenotype, complications, therapeutic requirements, and familial aggregation were recorded. We defined “aggressive disease” any ulcerative colitis (UC) requiring immunomodulators (IMM) and/or biological agents (BA) and/or resective surgery (RS), or any Crohn's disease (CD) requiring BA and/or RS.

Results: We identified 71 Gypsy patients (24 UC, 47 CD), 43 (61%) of them females, with a median age of 24 (IQR: 19–29) years at diagnosis, a median follow-up of 72 (IQR: 38–144) months, and a rate of active smoking at diagnosis of 21% and 49% for UC and CD, respectively.

Fourteen (58%) UC patients had extensive disease and only in 2 (8%) the disease was confined to the rectum. In 45 (96%) CD patients the disease was ileal or ileocolonic, with only 2 (4%) with isolated colonic involvement. Forty-nine per cent of CD patients suffered from stricturing or penetrating disease. Twelve (26%) CD patients developed perianal disease and 5 (11%) had upper G-I tract involvement. Twenty-five (35%) patients developed extraintestinal manifestations/complications, 12 (17%) intestinal complications. Steroid dependency and refractoriness occurred in 49% and 21% of patients, respectively. Seventy-eight per cent, 39% and 30% of cases (mainly among CD patients) required IMM, BA, and RS, respectively. Thirty-four (72%) CD and 16 (67%) UC had an “aggressive” behaviour.

Thirty-four patients (48%) had a total of 66 (40 first degree, 26 second degree) relatives with IBD, with a median of 2 (IQR: 1–3) relatives/patient.

Conclusions: In Gypsy patients, IBD has an “aggressive” behaviour (as judged by their therapeutic requirements) in almost 3/4 cases, and shows a rate of familial aggregation markedly higher than that reported in Caucasian patients.

1. Hou et al. AJG 2009; 104:2100–2109.