The impact of genetics on Crohn's disease.
OBJECTIVE
Reports focusing on the familiarity and "pedigree" of patients with Crohn's Disease (CD) are increasing. The study of the role of genetics as a predisposing factor in providing the ideal milieu upon which environmental agents and immuno-inflammatory responses may act, could be paramount in finding the pith of the etiopathogenesis of this disease.


METHODS
In order to determine the impact of familiarity on CD, a series of 187 patients, managed between January 1965 and January 1997, was subdivided into two groups. In group I (145 pts.), the family history relied only on direct information from the patient, while in group II (42 pts.) a prospective study was carried out involving both close and distant relatives who were interviewed and, in some cases, clinically investigated.


RESULTS
In this study, relatives with suspected CD were 9 out of 122 in group I patients (7.4%), while in the more detailed assessment of group II, 18 out of 42 cases (43%) had an ascertained CD familiarity.


CONCLUSIONS
The importance of familiarity in the pathogenesis of CD may be higher than expected if properly sought for. Reports on the possibility that the onset of CD may be strongly influenced by genetics, favor our hypothesis that the true etiology may find its base in a hemolymphatic disorder of the mesentery followed by superimposed inflammatory responses.
Del Gaudio
A
A
Department of Surgery, University of Bologna, School of Medicine, Italy.
Panettiere
P
P
Marchetti
L
L
Accorsi
D
D
Fuzzi
N
N
D000293:Adolescent; D000328:Adult; D003082:Colectomy; D003424:Crohn Disease / Q000175:diagnosis / Q000235:genetics* / Q000601:surgery; D005260:Female; D005820:Genetic Testing; D006801:Humans; D008297:Male; D008875:Middle Aged; D010348:Patient Care Team