A Systematic Review of Monogenic Inflammatory Bowel Disease

Overview

Journal Clin Gastroenterol Hepatol

Specialty Gastroenterology

Date 2021 Mar 22

PMID 33746097

Citations 35

Authors

Ryusuke Nambu

Neil Warner

Daniel J Mulder

Daniel Kotlarz

Dermot P B McGovern

Judy Cho

Christoph Klein

Scott B Snapper

Anne M Griffiths

Itaru Iwama

Aleixo M Muise

Affiliations

Soon will be listed here.

Abstract

Background & Aims: Advances in genomic technologies have led to increasing reports of monogenic inflammatory bowel disease (IBD). Here, we systematically review the literature to determine the clinical features, genetic profile, and previously used treatment strategies in monogenic IBD.

Methods: A systematic review of MEDLINE articles published between January 2000 and December 2020 was conducted. A total of 750 individual monogenic IBD cases were identified from 303 eligible articles.

Results: The most frequently reported monogenic IBD genes were IL10RA/B, XIAP, CYBB, LRBA, and TTC7A. In total, 63.4% of patients developed IBD before 6 years of age, 17.4% developed IBD between ages 10 and 17.9 years, and 10.9% developed IBD after age 18. There was a substantial difference between these age groups and the underlying monogenic disorders. Only 31.7% had any history of extraintestinal comorbidity (EIC) before IBD onset, but 76.0% developed at least 1 EIC during their clinical course. The most common EICs were atypical infection (44.7%), dermatologic abnormality (38.4%), and autoimmunity (21.9%). Bowel surgery, biologic therapy, and hematopoietic stem cell transplantation were performed in 27.1%, 32.9%, and 23.1% of patients, respectively.

Conclusions: Monogenic IBD cases, although rare, have varied extraintestinal comorbidities and limited treatment options including surgery and transplant. Early identification and improved understanding of the characteristics of the genes and underlying disease processes in monogenic IBD is important for effective management.

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