Family history of inflammatory bowel disease in uveitis patients without bowel disease

Purpose Patients with inflammatory bowel disease (IBD) have an increased incidence of ocular inflammation. The goal of this study is to determine whether patients with ocular inflammation are more likely to have a family history of IBD. Methods. Charts of 1816 patients seen in the uveitis clinic at the University of Illinois between 1981-1996 were reviewed. Only patients with idiopathic ocular inflammation were included; patients with evidence of an underlying etiology for their inflammation (e.g. sarcoidosis, JRA) were excluded. Patients with a personal history of IBD were also excluded. FTA-ABS, ACE, lysozyme, chest x-ray and relevant H LA typing was performed on all patients. All patients were specifically asked about a family history of IBD. Results. 1331 patients with idiopathic ocular inflammation were identified. Twenty-five (1.9%) had a family history of IBD. Of these, 20 (1.5%) had a family history of ulcerative colitis and 5 (0.4%) had a family history of Crohn's disease. The prevalence of ulcerative colitis and Crohn's disease in the general population is 0.0750.15% and 0.009-0.05% respectively. Chronic iridocyclitis was the entity most frequently associated with a positive family history of IBD (48%), followed by recurrent acute iridocyclitis (20%), acute iridocyclitis (16%), intermediate uveitis (8%), episcleritis (4%), scleritis (4%). Six of the 25 patients (24%) were HLA-B27 positive. Conclusions. The prevalence of a family history of IBD in patients with ocular inflammation is higher than the prevalence of IBD in the general population. This suggests that IBD in a family may be a risk factor for ocular inflammation.