Crohn's Disease in Sibling

Althogh familial incidence of Crohn's disease is very low in Japan, in our hospital two cases of this disease in siblings were found. Case 1 : A 15-year-old male (younger brother). In March 1976 he had a pain in the ileocecal region and underwent appendectomy. However, the appendix was normal, and s a tumor was found in the ileocecal region. An upper GI series indicated a stricture and a fistulation in the terminal region of the ileum ; the patient was diagnosed as having Crohn's disease. A celiotomy was done and the ileocecal resion was resected. The excised specimen revealed a longitudinal ulcer in the ileum and a fistule in the mesentery. The patient has shown no signs of recurrence and is in good health today, 15 years after the operation. Case 2: A 29-year-old male (older brother). The patient recieved appendectomy seven years ago (at age 22). He has admitted to our hospital in March 1988 with abdominal gain; and was given barium enema which revealed a stricture and a fistulation in the terminal region of the ileum, as well as a stricture in the sigmoid colon. As his young brother had Crohn's disease, we suspected it in this patient also. Resection of 150 cm of the ileum as well as the sigmoid colon were done. The excised ileum showed a longitudinal ulcer and skip lesions. The patient has shown no signs of recurrence, three years after the operation. A study of the HLA antigen revealed that among, all the HLA antigen reported in Japan to have a correlation with Crohn's disease, the only BW-61 was in Case 2 (older brother).