title: Anticipation in familial Crohn's disease.
abstract: BACKGROUND
  Offspring with a family history of Crohn's disease have an earlier age of onset than their parents. This might be due to genetic anticipation, characterised by earlier and/or more severe disease in subsequent generations.
  
  
  OBJECTIVE
  To investigate the possibility of genetic anticipation in affected parent-child pairs with Crohn's disease from France and Belgium.
  
  
  METHODS
  In a cohort of 160 multiply affected families with Crohn's disease, 57 parent-first affected child pairs were detected. Clinical characteristics (age at diagnosis, disease extent, and type) of both parents and children were registered and compared.
  
  
  RESULTS
  Children were younger than their parents at diagnosis in 48/57 (84%) pairs. The median age at diagnosis was 16 years younger in children than in parents (p < 0.0001). However, the difference was related to the age at diagnosis in the parents and was not present in 12 parent-child pairs with an early age at diagnosis for the parents. In most cases, disease extent and type were not considered more severe in children than in parents. Parental sex affected neither age at diagnosis nor extent and type of disease in children.
  
  
  CONCLUSIONS
  Patients in the second affected generation acquire their disease at an earlier time in life in some but not all familial cases of Crohn's disease. Several explanations including genetic anticipation and environmental factors might explain this phenomenon.
authors.affiliation: Registre des Maladies Inflammatoires du Tube Digestif du Nord-Ouest de la France (EPIMAD), Service D'Hépato-Gastroentérologie, Hôpital Huriez, CH et U Lille, France.
authors.forename: B
authors.initials: B
authors.lastname: Grandbastien
authors.forename: M
authors.initials: M
authors.lastname: Peeters
authors.forename: D
authors.initials: D
authors.lastname: Franchimont
authors.forename: C
authors.initials: C
authors.lastname: Gower-Rousseau
authors.forename: D
authors.initials: D
authors.lastname: Speckel
authors.forename: P
authors.initials: P
authors.lastname: Rutgeerts
authors.forename: J
authors.initials: J
authors.lastname: Belaïche
authors.forename: A
authors.initials: A
authors.lastname: Cortot
authors.forename: R
authors.initials: R
authors.lastname: Vlietinck
authors.forename: J F
authors.initials: JF
authors.lastname: Colombel
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D002648:Child; D015331:Cohort Studies; D003106:Colon / Q000473:pathology; D003424:Crohn Disease / Q000453:epidemiology / Q000235:genetics* / Q000473:pathology; D004198:Disease Susceptibility; D005260:Female; D006801:Humans; D007421:Intestine, Small / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010290:Parents; D018709:Statistics, Nonparametric