Inflammatory Bowel Disease in a Family

Abstract

The mother and all three children of a family developed inflammatory disease of the bowel within a 5-year period. Shortly before ulcerative procititis occurred in the mother the family was living in a section of Germany where the water supply was poorly controlled hygienically. The two sons developed severe progressive granulomatous colitis, leading to total colectomy within 6 months of each other. Similar colon pathology characterized by deep longitudinal ulcerations was found. Disease occurred in the previously uninvolved small bowel of both children less than 1 year after surgery. The daughter's illness was manifested by aphthous stomatitis and arthritis. Diarrhea, weight loss, and fever then occurred with severe ileocolitis evident radiologically. Glucose-6-phosphate dehydrogenase values, immunoglobulin levels, and a chromosome analysis were unremarkable. Experience with this family supports the concept of a hereditary mechanism still unidentified in the cause of inflammatory bowel disease which may be precipitated by environmental stimuli.