Family History of Inflammatory Bowel Disease in Patients with Idiopathic Ocular Inflammation

Purpose: To determine the prevalence of a family history (FMH) of inflammatory bowel disease (IBD) in patients with idiopathic ocular inflammation (OI).

Design: Retrospective observational study.

Methods: Medical records of idiopathic OI patients seen between January 1995 and June 2005 in the University of Illinois Uveitis Clinic were screened for a FMH of IBD. FMH included first, second, and third degree relatives.

Results: 727 (32.8%) patients had idiopathic OI. 26 of 727 (3.6%) and 10 of 727 (1.4%) reported a FMH of ulcerative colitis (UC) and Crohn's disease, respectively. 16 (2.2%) patients with a FMH of indeterminate colitis were excluded from subsequent comparisons. The prevalence of a FMH of IBD among patients with idiopathic OI was 3- to 15-fold higher than the prevalence of UC and Crohn's in the general population (0.055% to 0.27%). Keratoiritis was more common and granulomatous disease less frequent in patients with a FMH of IBD (P = .014 and .019). Patients tested 26.3% with a FMH of IBD, and 66.7% of patients tested with IBD themselves, were HLA-B27 positive (odds ratio [OR] 5.6, 95% confidence interval [CI] 0.77 to 45.8), compared with 40.1% of patients with neither (OR 1.87, 95% CI 0.61 to 6.83).

Conclusions: A FMH of IBD may be an independent risk factor for the development of OI. In contrast to the subgroup of patients with a personal history of IBD, HLA-B27 may not be an appropriate marker in the subgroup of patients with merely a FMH of IBD, emphasizing the importance of investigating other immunologic factors that may predispose patients with IBD and their relatives to OI.