Article
Why children with inflammatory bowel disease are diagnosed at a
younger age than their affected parent
J C W Leea, S Bridgerb, C McGregorb, A J S Macphersonb, J E Lennard Jonesa
a St
Mark's Hospital, Northwick Park, Harrow, Middlesex, UK, b Department of
Medicine, King's College School of Medicine and Dentistry, London, UK
Correspondence to: Professor J E Lennard-Jones, 72 Cumberland Street, Woodbridge, Suffolk IP12 4AD, UK.
Accepted for publication 13 January 1999
BACKGROUND
Genetic anticipation has
been proposed to explain observed age differences at diagnosis of
Crohn's disease in affected parents and offspring.
AIMSTo compare affected
parent-child pairs with Crohn's disease and ulcerative colitis with a
control group of non-familial patients with inflammatory bowel disease
(IBD) in order to quantify whether ascertainment bias could account for
this effect.
METHODS137 affected parent-child
pairs from 96 families and 214 patients with sporadic IBD were studied.
Age at onset of symptoms and diagnosis were ascertained by interview
and disease confirmed from clinical records.
RESULTSOf the 137 affected
parent-child pairs, 50 had Crohn's disease only, 51 had ulcerative
colitis only, and in 36, one had Crohn's disease and the other
ulcerative colitis. The median age of parents at diagnosis was 17.5 years older, 16 years older, and 18 years older in the Crohn's
disease, ulcerative colitis, and mixed disease families respectively
(p<0.001 in each case). These observed age differences were compatible
with those predicted from the regression lines of years of birth
against age at diagnosis for the non-familial IBD patients. No evidence
was found for an effect of parental sex on age at diagnosis or disease
extent in offspring.
CONCLUSIONSThere was no evidence
of genetic anticipation or genomic imprinting of age at diagnosis in
this sample of IBD families. Ascertainment bias is responsible for the
age differences at diagnosis between affected parents and children.
Keywords: Crohn's disease; ulcerative colitis; familial; genetic anticipation
© 1999 by Gut
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