title: Clustering of (auto)immune diseases with early-onset and complicated inflammatory bowel disease.
abstract: Studies in adult inflammatory bowel disease (IBD) patients have highlighted associations with genetic and serologic markers and suggest an association with disease location, behaviour and natural history. Data on patients with Crohn's disease (CD, n=80), ulcerative colitis (UC, n=15) and indeterminate colitis (n=4) were collected. All individuals were analysed for CARD15 R702W, G908R and L1007fs for toll-like receptor 4 (TLR4) Asp299Gly and for anti-Saccharomyces cerevisiae antibodies (ASCA) and atypical perinuclear antineutrophil cytoplasmatic antibodies (pANCA). After a mean of 10.7 years of follow up, the disease behaviour changed in 45% of CD patients, in contrast to disease location, where only 12.5% had a change (p<0.001). The younger the age at diagnosis, the more patients presented with colonic disease (p=0.021). Also, more TLR4 Asp299 Gly variants were found when the age at onset was younger (p=0.018). A large number of concomitant diseases were observed. There was no difference in the prevalence of TLR4 variants nor ASCA or pANCA between the patients with or without concomitant diseases. Patients who progressed more often needed surgery as compared to patients who remained free of stenosing or fistulising disease (27/32 or 84% versus 3/35 or 8.6%, respectively, p<0.0001) and more often had concomitant immune-mediated diseases and a trend for more seroreactivity towards ASCA.
authors.affiliation: Department of Paediatric Gastroenterology, University Hospital Gasthuisberg, Herestraat 49, 3000 Leuven, Belgium.
authors.forename: Mirjam
authors.initials: M
authors.lastname: Bueno de Mesquita
authors.forename: Marc
authors.initials: M
authors.lastname: Ferrante
authors.forename: Liesbet
authors.initials: L
authors.lastname: Henckaerts
authors.forename: Marie
authors.initials: M
authors.lastname: Joossens
authors.forename: Virginie
authors.initials: V
authors.lastname: Janssens
authors.forename: Tibor
authors.initials: T
authors.lastname: Hlavaty
authors.forename: Marie
authors.initials: M
authors.lastname: Pierik
authors.forename: Sofie
authors.initials: S
authors.lastname: Joossens
authors.forename: Nele
authors.initials: N
authors.lastname: Van Schuerbeek
authors.forename: Gert
authors.initials: G
authors.lastname: Van Assche
authors.forename: Paul
authors.initials: P
authors.lastname: Rutgeerts
authors.forename: Severine
authors.initials: S
authors.lastname: Vermeire
authors.forename: Ilse
authors.initials: I
authors.lastname: Hoffman
mesh_terms: D000367:Age Factors; D001327:Autoimmune Diseases / Q000453:epidemiology* / Q000235:genetics*; D017931:DNA Primers / Q000235:genetics; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D019084:Fluorescent Antibody Technique, Indirect; D005838:Genotype; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000453:epidemiology* / Q000235:genetics*; D008297:Male; D053473:Nod2 Signaling Adaptor Protein / Q000235:genetics; D010641:Phenotype; D011110:Polymorphism, Genetic / Q000235:genetics; D051197:Toll-Like Receptor 4 / Q000235:genetics; D055815:Young Adult
chemical_list: D017931:DNA Primers; C429018:NOD2 protein, human; D053473:Nod2 Signaling Adaptor Protein; C495345:TLR4 protein, human; D051197:Toll-Like Receptor 4