Familial ulcerative colitis in Israeli Jews: its prevalence and clinical severity compared to sporadic disease.
BACKGROUND
A family history of inflammatory bowel disease (IBD) is present in some ulcerative colitis (UC) patients. We aimed to investigate the familial occurrence of UC and its impact on disease severity.


METHODS
A structured questionnaire was distributed to patients with UC. Parameters pertaining to disease severity were compared for patients with or without positive family history of IBD.


RESULTS
The study group consisted of 168 UC patients with a total of 952 first degree relatives. Positive family history for IBD in a first degree relative was reported in 24 patients (14%). Six of the 336 parents (1.8%) had IBD (all with UC). There were 13 siblings with IBD (4 CD, 9 UC) out of 249 (5.4%). Seven of 376 (1.9%) offsprings had IBD (4 CD, 3 UC). Familial patients were more commonly females and have reported significantly more disease exacerbations than the sporadic group (17.7±15 versus 6.8±11, respectively, p=0.006). On multivariate analysis, familial disease was significantly and independently associated with both female sex (OR 4.1, 95% CI 1.1-14.9, p=0.04) and more exacerbations per year (annual OR 1.05, 95% CI 1.01-1.1, p=0.02). However, similar proportions of sporadic and familial patients wherever hospitalized, underwent colectomy or were treated by immune-suppressors.


CONCLUSIONS
Familial occurrence of UC is not uncommon among Jewish patients in Israel. The familial-genetic component may preferentially influence disease occurrence among females, and is possibly associated with more disease flares although other parameters of disease severity do not seem to be impacted.
Sheba Medical Center and Sackler School of Medicine, Tel-Aviv University, Israel (Shomron Ben-Horin, Shira Tamir, Uri Kopylov, Lion Katz, Moshe Nadler, Alon Lang, Benjamin Avidan).
Shomron
S
Ben-Horin
Sheba Medical Center and Sackler School of Medicine, Tel-Aviv University, Israel (Shomron Ben-Horin, Shira Tamir, Uri Kopylov, Lion Katz, Moshe Nadler, Alon Lang, Benjamin Avidan).
Shira
S
Tamir
Sheba Medical Center and Sackler School of Medicine, Tel-Aviv University, Israel (Shomron Ben-Horin, Shira Tamir, Uri Kopylov, Lion Katz, Moshe Nadler, Alon Lang, Benjamin Avidan).
Uri
U
Kopylov
Sheba Medical Center and Sackler School of Medicine, Tel-Aviv University, Israel (Shomron Ben-Horin, Shira Tamir, Uri Kopylov, Lion Katz, Moshe Nadler, Alon Lang, Benjamin Avidan).
Lion
L
Katz
Sheba Medical Center and Sackler School of Medicine, Tel-Aviv University, Israel (Shomron Ben-Horin, Shira Tamir, Uri Kopylov, Lion Katz, Moshe Nadler, Alon Lang, Benjamin Avidan).
Moshe
M
Nadler
Sheba Medical Center and Sackler School of Medicine, Tel-Aviv University, Israel (Shomron Ben-Horin, Shira Tamir, Uri Kopylov, Lion Katz, Moshe Nadler, Alon Lang, Benjamin Avidan).
Alon
A
Lang
Sheba Medical Center and Sackler School of Medicine, Tel-Aviv University, Israel (Shomron Ben-Horin, Shira Tamir, Uri Kopylov, Lion Katz, Moshe Nadler, Alon Lang, Benjamin Avidan).
Benjamin
B
Avidan
Rambam Health Care Campus & Bruce Rappaport School of Medicine, Technion Israel Institute of Technology, Haifa (Yehuda Chowers).
Yehuda
Y
Chowers
Crohn’s disease; inheritance; ulcerative colitis