Familial occurrence of inflammatory bowel disease in celiac disease

Background: The authors have previously reported a possible increased risk of the familial occurrence of Crohn's disease in patients with celiac disease. Aim: The aim of the current study was to evaluate in a case-control study the familial occurrence of inflammatory bowel disease (IBD) in first-degree relatives of patients with celiac disease. Methods: One hundred eleven consecutive patients with biopsy-proven celiac disease were interviewed to ascertain whether IBD was present in first-degree relatives. The number of relatives, their ages, and possible IBD status were collected in a questionnaire. When a diagnosis of familial IBD was reported, the diagnosis was checked in the hospital records. Two hundred twenty-two controls matched for age and sex (I I I from the general population and I I I from orthopedic wards) were also interviewed regarding the possible occurrence of IBD in first-degree relatives. The chi(2) test was used to evaluate the difference in proportion of familial occurrence of IBD among individuals with celiac disease and controls. Results: Among 600 first-degree relatives of patients with celiac disease, 10 cases of IBD were identified among first-degree relatives (7 cases of ulcerative colitis and 3 cases of Crohn's disease), whereas only I case of IBD was identified among the 1,196 first-degree relatives of control patients (p < 0.01). When ulcerative colitis and Crohn's disease were analyzed separately, only the prevalence of ulcerative colitis was statistically significant (p less than or equal to 0.02). Conclusions: This case-control study shows that there is a significantly increased prevalence of familial ulcerative colitis in patients with celiac disease. There was no significant increase in the prevalence of Crohn's disease in patients with celiac disease. The possible role of this association is discussed.