P623. Similar clinical characteristics of familial and sporadic inflammatory bowel disease
S.H. Chung1, S.J. Park1, H.S. Lee2, J.H. Cheon1, S.P. Hong1, T.I. Kim1, W.H. Kim1, 1Yonsei University College of Medicine and institute of Gastroenerology, South Korea, 2Yonsei University College of Medicine, Department of Biostatistics, South Korea
Inflammatory bowel disease (IBD) is caused by complex interaction between genetic and environmental factors.
In spite of several studies of familial IBD, we do not have sufficient information about the clinical characteristics in familial IBD. The aim of this study is to investigate differences of clinical characteristics and disease courses between familial and sporadic IBD patients.
We obtained clinical data on Crohn's disease (CD, 691 cases) and ulcerative colitis (UC, 1113 cases) in Severance Hospital, Yonsei University College of Medicine from Jan. 2005 to Feb. 2012. Seventeen patients (2.5%) with CD and 27 patients (2.4%) with UC were identified to have familial history of IBD. For each control case, 3 times age- and sex-matched CD and UC patients who had no family history of IBD were randomly selected based on the electronic medical data. We compared the clinical characteristics and disease course of familial CD/UC patients with sporadic CD/UC patients, respectively.
There were no significant differences of age at diagnosis, age at symptom onset, main symptom at diagnosis (abdominal pain, diarrhea, weight loss, fever, abdominal mass, hematochezia), extraintestinal manifestation, location, behavior of disease activity, number of hospitalizations, number of operations, operation type, causes of operation and operation rate, number of relapses, medical treatment with 5-ASA, oral steroid, and azathioprine between familial and sporadic CD and familial and sporadic UC patients, respectively. Median (min-max) follow up peroids after diagnosis of familial CD patients and sporadic CD patients were 84 (24–312) months and 36 (8–240) months, respectively (P = 0.008). But there was no significant difference of follow up peroids after diagnosis of familial UC patients and sporadic UC patients. Familial CD patients more frequently used anti TNF agents than sporadic CD patients (3/17, 17.6% vs 0/21, 0%, P = 0.014). Longer follow up period of disease might result in more usage of anti-TNF antibody in familial CD patients than sporadic CD patients.
Clinical characteristics between familial IBD and sporadic IBD patients do not seem to be significantly different. A family history of IBD does not seem to be an important predictive factor affecting clinical characteristics or disease course. The duration of disease might be more important factor predictive of disease course rather than the familial history of IBD.