title: Crohn's disease severity in familial and sporadic cases.
abstract: BACKGROUND
  Having a relative with inflammatory bowel disease increases the risk for Crohn's disease but may also increase its severity in affected patients.
  
  
  OBJECTIVE
  To evaluate the influence of a family history on Crohn's disease course and severity.
  
  
  METHODS
  1316 patients followed in the same unit were studied retrospectively. Age at onset, duration of illness, site, and extent of disease were determined in patients with and without a family history. Additionally, disease severity was estimated by the need for medical therapy (steroid and immunosuppressive requirement) and the frequency and extent of excisional surgery.
  
  
  RESULTS
  152 (12%) patients had a family history of inflammatory bowel disease. Duration of follow up was longer in patients with a family history and there were more operations for perforating complications in familial cases. However, the importance of medical therapy, and the incidence and extent of excisional surgery were similar in familial and and sporadic cases. Kaplan-Meier estimated time to prescription of immunosuppressive drugs and first intestinal resection were similar in familial and sporadic cases. When the 152 patients with familial Crohn's disease were paired for sex, location of disease at onset, date of birth, and date of diagnosis with 152 patients sporadic Crohn's disease, the disease severity remained similar in the two groups of paired patients.
  
  
  CONCLUSIONS
  Patients with Crohn's disease and a family history of inflammatory bowel disease do not have a more severe course.
authors.affiliation: Service de Gastroentérologie et Nutrition, Hôpital Rothschild, Paris, France.
authors.forename: F
authors.initials: F
authors.lastname: Carbonnel
authors.forename: G
authors.initials: G
authors.lastname: Macaigne
authors.forename: L
authors.initials: L
authors.lastname: Beaugerie
authors.forename: J P
authors.initials: JP
authors.lastname: Gendre
authors.forename: J
authors.initials: J
authors.lastname: Cosnes
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D003424:Crohn Disease / Q000235:genetics* / Q000473:pathology / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013997:Time Factors
chemical_list: D007166:Immunosuppressive Agents