title: Influence of a Positive Family History on the Clinical Course of Inflammatory Bowel Disease.
abstract: OBJECTIVE
  Previous studies on the difference in phenotypes and disease course between familial and sporadic inflammatory bowel disease (IBD) have been controversial, although family history is considered to increase the risk of developing IBD.
  
  
  METHODS
  The influence of family history on phenotype and disease course of IBD was analysed in 2805 Korean patients with Crohn's disease (CD) and 3266 with ulcerative colitis (UC). Familial IBD was defined as the existence of one or more first-, second- and/or third-degree relatives affected with CD or UC.
  
  
  RESULTS
  A positive family history of IBD was noted in 191 patients with CD (6.8%) and 212 patients with UC (6.5%). In the patients with CD, the probability of anti-TNF use was higher in the familial cases than in the sporadic cases (56.3 vs 43.4%, respectively, at 10 years, p = 0.019). When analysed after excluding patients who had undergone intestinal resection within 1 year of diagnosis, the cumulative probability of intestinal resection was higher in the familial cases than in the sporadic cases (55.0 vs 32.2%, respectively, at 10 years; p = 0.007). In multivariate analysis, family history was an independent risk factor for the time to first intestinal resection in patients with CD (hazard ratio: 1.61, 95% confidence interval: 1.13-2.29; p = 0.009). In patients with UC, younger age at diagnosis and more females were observed in the familial cases (p < 0.001).
  
  
  CONCLUSIONS
  The present study suggests the possibility of a more aggressive clinical course of CD in familial compared with sporadic cases.
authors.affiliation: Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
authors.forename: Sung Wook
authors.initials: SW
authors.lastname: Hwang
authors.affiliation: Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
authors.forename: Min Seob
authors.initials: MS
authors.lastname: Kwak
authors.affiliation: Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
authors.forename: Wan Soo
authors.initials: WS
authors.lastname: Kim
authors.affiliation: Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
authors.forename: Jeong-Mi
authors.initials: JM
authors.lastname: Lee
authors.affiliation: Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
authors.forename: Sang Hyoung
authors.initials: SH
authors.lastname: Park
authors.affiliation: Health Screening and Promotion Center, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
authors.forename: Ho-Su
authors.initials: HS
authors.lastname: Lee
authors.affiliation: Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
authors.forename: Dong-Hoon
authors.initials: DH
authors.lastname: Yang
authors.affiliation: Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
authors.forename: Kyung-Jo
authors.initials: KJ
authors.lastname: Kim
authors.affiliation: Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
authors.forename: Byong Duk
authors.initials: BD
authors.lastname: Ye
authors.affiliation: Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
authors.forename: Jeong-Sik
authors.initials: JS
authors.lastname: Byeon
authors.affiliation: Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
authors.forename: Seung-Jae
authors.initials: SJ
authors.lastname: Myung
authors.affiliation: Department of Colon and Rectal Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
authors.forename: Yong Sik
authors.initials: YS
authors.lastname: Yoon
authors.affiliation: Department of Colon and Rectal Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
authors.forename: Chang Sik
authors.initials: CS
authors.lastname: Yu
authors.affiliation: Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
authors.forename: Jin-Ho
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea sky@amc.seoul.kr.
authors.forename: Suk-Kyun
authors.initials: SK
authors.lastname: Yang
mesh_terms: D000293:Adolescent; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D016022:Case-Control Studies; D003082:Colectomy; D003131:Combined Modality Therapy; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D020022:Genetic Predisposition to Disease; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000175:diagnosis / Q000235:genetics* / Q000628:therapy; D008297:Male; D008487:Medical History Taking; D008875:Middle Aged; D010641:Phenotype; D016016:Proportional Hazards Models; D012042:Registries; D056910:Republic of Korea; D012307:Risk Factors; D055815:Young Adult
chemical_list: D000893:Anti-Inflammatory Agents
keywords: Crohn’s disease; familial history; ulcerative colitis