Gastroenterology

Gastroenterology

Volume 120, Issue 4, March 2001, Pages 816-819
Gastroenterology

Alimentary Tract
Inflammatory bowel disease in spouses and their offspring,☆☆

https://doi.org/10.1053/gast.2001.22574Get rights and content

Abstract

Background & Aims: The rarity of inflammatory bowel disease (IBD) in both husband and wife is often given as an argument against an infectious origin. We registered conjugal instances of IBD in Northern France and in Belgium between 1989 and 2000. Methods: Couples were assigned to group A if both partners had symptoms of IBD before cohabitation, to group B if one spouse had IBD before cohabitation and the other experienced first symptoms afterwards, and to group C if both partners got the disease after cohabitation. Risk of IBD was assessed in their offspring. Results: Thirty conjugal instances were registered. Seventeen were concordant for Crohn's disease and 3 for ulcerative colitis; 10 were mixed. Two belonged to group A, 6 to group B, and 22 to group C. In group C, IBD occurred in the first affected spouse an average of 9 years after cohabitation and in the second spouse an average of 8.5 years later. Group C conjugal forms were more frequent than expected by chance (P < 0.02). Fifty-four children were born to 25 couples; among them 9, of whom 4 were siblings, developed Crohn's disease at a median age of 15 years. Conclusions: The frequency of conjugal forms of IBD suggests an etiologic role for environmental factors. Offspring of 2 affected parents have a high risk of developing IBD.

GASTROENTEROLOGY 2001;120:816-819

Section snippets

Patients

This study was conducted in 3 French departments (Nord, Pas-de-Calais, and Somme) through the Registre des Maladies Inflammatoires Chroniques de l'Intestin of Northern France (EPIMAD) and in 4 referral centers in Belgium (Leuven, Liège, and 2 in Brussels). The total populations of these areas was 4,516,884 for Northern France and 10,170,226 for Belgium. Gastroenterologists representing this population were asked to refer conjugal forms of IBD.

All the patients' family data were collected in a

Results

From January 1989 to July 2000, 30 couples with IBD were identified: 15 in Northern France and 15 in Belgium. There was no geographic clustering. None of the couples were consanguineous. Two couples belong to the same family, affected through 2 successive generations. None of the pairs were Jewish. Two couples were assigned to group A, 6 to group B, and 22 to group C (Table 1).Twenty couples (66%) were concordant for IBD, 17 for CD, and 3 for UC. Within the 17 couples with CD, there was a

Discussion

Given the population prevalence of IBD, the frequency of conjugal pairs developing IBD after cohabitation in Northern France and in Belgium seems to be greater than might be expected by chance. Although we recognize that probability values may be influenced by variations in the estimate of prevalence, we think the difference between observed and expected-by-chance cases is valid. Based on the data from several registries, the prevalence of IBD has been estimated to be 10–15 times the incidence.

References (20)

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Supported partly by the Association F. Aupetit, Institut de la Veille Sanitaire, INSERM (grant 92/R/2), CH et U de Lille, and the Ferring and Astra (IRMAD grant) companies.

☆☆

Address requests for reprints to: Jean–Frédéric Colombel, M.D., Clinique des maladies de l'Appareil Digestif et de la Nutrition, Hôpital Huriez, CHRU Lille, 59037, Lille, France. e-mail: [email protected]; fax: (33) 3-20-44-47-13; or S. Debeugny, M.D., Registre EPIMAD, Service d'Epidémiologie et de Santé Publique, Hôpital Calmette, CHRU Lille, France. Fax: (33) 3-20-44-69-45.

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