Clinical-alimentary tractSubclinical intestinal inflammation: an inherited abnormality in Crohn’s disease relatives?☆
Section snippets
Patients and methods
Forty-nine patients with Crohn’s disease, which represents just <30% of all patients with Crohn’s disease in Iceland, were approached for these studies by mail and telephone, and all participated. Thirty-four of these patients were seen by 3 gastroenterologists (representing >80% of those under their care) at Reykjavik University Hospital, which provides acute medical service along with Reykjavik Hospital to the greater Reykjavik area (on the southwest coast with a population of 140,000). This
Intestinal inflammation in patients with Crohn’s disease and relatives
The calprotectin values in patients with Crohn’s disease (47 mg/L; CI, 27–95 mg/L) and their first-degree relatives (11 mg/L; CI, 9–14 mg/L) differed significantly (P < 0.0001) from controls (median, 4 mg/L; CI, 3–5 mg/L). There was no significant difference between fecal calprotectin concentrations in spouses (4 mg/L; CI, 3–6 mg/L) and controls. Figure 1 shows the data graphically.
Forty-three (88%) of the 49 patients with Crohn’s disease, 74 (49%) of the 151 first-degree relatives, and 2
Discussion
This study shows increased fecal calprotectin concentrations, indicative of subclinical intestinal inflammation, in 49% of the first-degree relatives of patients with Crohn’s disease. Of the models tested, the pattern of inheritance of elevated calprotectin concentrations among the relatives of patients with Crohn’s disease is most consistent with an additive model. This suggests that the abnormality responsible for this observation may represent a genetically determined (subclinical disease)
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Supported in part by a Biomedical Research Collaboration grant from the Wellcome Trust (ref. 048461).