Inflammatory bowel disease in children: the role of a positive family history

Roma, Elefthería; Panayiotou, Joanna; Pachoula, Joanna; Constantinidou, Catherin; Polyzos, A.; Zellos, Aglaia; Lagona, Evagelia; Mantzaris, Gerassimos J.; Syriopoulou, Vassiliki

doi:10.1097/meg.0b013e32832e2bd8

Cited by 15 publications

(21 citation statements)

References 36 publications

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“…Positive family history was found in 8.9% of the IBD cohort with no difference among the disease phenotypes. This finding is in accordance with that of 8.5% found in our previous study [ 22 ] where 6.1% of IBD children had a 1 st degree relative with IBD and very close to that of 7% found in another Mediterranean study [ 23 ].…”

Section: Discussionsupporting

confidence: 93%

P170 Paediatric inflammatory bowel disease in Greece: 30 years experience of a single center

Dimakou¹,

Pachoula²,

Chouliaras³

et al. 2012

Journal of Crohn's and Colitis

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BackgroundSignificant advances have been made in the care of children with inflammatory bowel disease (IBD). We aimed to describe the trends during the last 3 decades in the clinical presentation, management, and outcome of pediatric IBD at a single center.MethodsMedical records of children with IBD referred to a pediatric gastroenterology unit from January 1981 to December 2011 were reviewed retrospectively.ResultsA total of 483 children were diagnosed with IBD, with mean age at diagnosis of 9.6 years (range 6 months – 18 years). Ulcerative colitis (UC) was diagnosed in 267 (55.2%), Crohn’s disease (CD) in 167 (34.5%), and IBD unclassified (IBDU) in 49 (10.1%). Children with UC and IBDU were younger than those with CD [mean age at diagnosis 9.2, 8.9, and 10.5 years respectively; P (UC vs. CD)<0.01 and P (IBDU vs. CD)=0.028]. Patients received 5-ASA (96.6%), steroids (77.0%), thiopurines (50.2%), biological agents (14%), and 10% underwent surgical intervention. The cohort was divided into three subgroups according to the date of diagnosis; Group A: 1981-1989, Group B: 1990-1999, and Group C: 2000-2011. During the last two decades a significant increase in CD (Group A 18.5%, Group B 23.8%, Group C 48.8%; P<0.01) compared with the first decade with parallel decrease in UC (Group A 79.6%, Group B 71.9%, Group C 33.2%; P<0.001) was observed.ConclusionsMost children received 5-ASA, steroids, and immunomodulators. Patients with UC and IBDU were younger than those with CD. A significant increase in CD with parallel decrease in UC during the last decade was found.

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Section: Discussionsupporting

confidence: 93%

P170 Paediatric inflammatory bowel disease in Greece: 30 years experience of a single center

Dimakou¹,

Pachoula²,

Chouliaras³

et al. 2012

Journal of Crohn's and Colitis

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“…However, the male to female ratio varied widely in different studies across populations 243942. The age at onset and diagnosis did not vary significantly between those with and without a family history in our study, unlike previous studies that showed a younger age at onset for familial UC cases 121524. Probands with a family history had a significantly lower proportion of extensive colitis (27.6% vs. 43.2%).…”

Section: Discussioncontrasting

confidence: 84%

“…However, in some other studies a high concordance for both types of the disease was found 124041. The disease susceptibility may therefore be specific, and patients with UC have a greater chance of a family member being affected by UC rather than CD.…”

Section: Discussionmentioning

confidence: 87%

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Familial aggregation of inflammatory bowel disease in patients with ulcerative colitis

et al. 2017

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Background/AimsFamilial occurrence of inflammatory bowel disease (IBD) is well documented. Reports from Western countries have shown a higher familial occurrence of ulcerative colitis (UC) in first- and second-degree relatives than that in the Asian UC population. No data are currently available from the Indian subcontinent in this regard. We present our data on the familial aggregation of UC.MethodsRecords of patients with UC followed at the Inflammatory Bowel Disease Clinic at the All India Institute of Medical Sciences, New Delhi from August 2004 to January 2016 were reviewed. Details regarding the prevalence of family history and characteristics of these patients were recorded. Affected family members were contacted and disease characteristics were noted for assessment of familial aggregation.ResultsOf the 2,058 UC patients included in the analysis, a positive family history of IBD was confirmed in 31 patients (1.5%), 24 (77.4%) of whom had only first-degree relatives affected. All the affected relatives had UC and none had Crohn's disease. Among first-degree relatives, siblings were found to have the highest prevalence of IBD (53.3%), followed by parents (26.7%).ConclusionsThe probability of occurrence of IBD in family members of affected North Indian UC patients is lower than that reported in Western populations.

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“… 21 Despite the high percentage of consanguineous marriage, 32.6% prevalence found in this study is still lower than the 56% prevalence in the general Saudi population. 22 Only 9% positive family history of IBD was reported in this study, which is higher than 6.6% reported by Roma et al 23 but lower than the 11% reported from Wisconsin, USA; 24 15.3% reported in the central region of Saudi Arabia 15 and 31% reported in Kuwait. 11 This relatively low prevalence of positive family history in Saudi Arab children with IBD, a population with high prevalence of consanguinity, 22 is surprising and provides more support to the current etiologic theories are multifactorial and not only focus on genetic factors but also on environmental triggers, 1 immunoregulatory defects, 7 and microbial exposure.…”

Section: Discussioncontrasting

confidence: 50%

Characteristics of pediatric ulcerative colitis in Saudi Arabia: a multicenter national study

Mouzan

Saadah

AlSaleem

et al. 2015

Annals of Saudi Medicine

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BACKGROUNDDespite the extensive reporting of pediatric ulcerative colitis (UC) from industrialized developed countries, reports from developing countries are limited to small-case series from single centers. The objective of our large multicenter study was to determine the clinical, laboratory, endoscopic characteristics of UC in children from a developing country, Saudi Arabia.DESIGN AND SETTINGSA retrospective study of children diagnosed with UC under the age of 18 years during the period from 2003 to 2012.METHODSPatients enrolled from 15 medical centers from different regions in Saudi Arabia. A unified database collection form specifically designed for this study was completed by all participating centers.RESULTSA total of 188 children were diagnosed with UC during the study period (97 males [51.6%] and 91 females [48.4%]). The mean age at diagnosis was 9.1 years, and the mean duration of symptoms before diagnosis was 8.7 months. Consanguinity was present in 57 cases (32.6%), and the family history of inflammatory bowel disease (IBD) was noted in 16 cases (9%). The most common clinical presentation was blood in stool (90%), followed by diarrhea (86%) and abdominal pain (62%). Laboratory investigations revealed elevated erythrocyte sedimentation rate (82%), anemia (75%), thrombocytosis (72%), and hypoalbuminemia (33%). The extent of the disease was pan colonic in 46.1%, and confined to left side of colon and rectum in 23% and 9.6% of the cases, respectively.CONCLUSIONThis demographically pediatric IBD retrospective study revealed age-related variation in the distribution of IBD. Clinical presentation, with a high prevalence of positive consanguinity and positive family history, was noted in young patients with UC. The data from this study indicate that UC is increasingly recognized in Saudi Arabia and show many similarities to data from North America and Europe.

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Inflammatory bowel disease in children: the role of a positive family history

Abstract: Children with familial IBD had earlier onset of disease compared with those with sporadic IBD. However, this had no significant impact on the clinical phenotypes, the course and/or the outcome of disease.

Cited by 15 publications

References 36 publications

P170 Paediatric inflammatory bowel disease in Greece: 30 years experience of a single center

P170 Paediatric inflammatory bowel disease in Greece: 30 years experience of a single center

Familial aggregation of inflammatory bowel disease in patients with ulcerative colitis

Characteristics of pediatric ulcerative colitis in Saudi Arabia: a multicenter national study

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