Clinical Allergy, 1979, Volutne 9, pages 221-223
Atopic disease in ulcerative colitis and Crohn's disease
S. M. PUGH, J. RHODES, J. F. MAYBERRY, D. L. ROBERTS, R. V. HEATLEY and R. G. NEWCOMBE Department of Gastroenterology and University Department of Medical Statistics, University Hospital of Wales, Cardiff (Received 4 December 1978; accepted for publication 5 December 1978J
Summary Three hundred patients with ulcerative colitis, 200 with Crohn's disease and matched control subjects completed questionnaires about atopic disease. They were asked whether they had ever suffered from asthma, hay fever, allergic rhinitis or eczema; in ulcerative colitis all of these features occurred with twice the frequency, but in Crohn's disease only eczema was more common than in controls. Introduction Although the pathogenesis of both ulcerative colitis and Crohn's disease is poorly understood some recent work would suggest that a hypersensitivity reaction involving IgE may play some part in ulcerative colitis (Heatley et al., 1975b; Mani et al., 1976; Dronfield & Langman, 1977). If this is true one would anticipate that patients with colitis may suffer from atopic illnesses more often than a control population. We have questioned patients with ulcerative colitis and Crohn's disease to determine whether they had an increased prevalence of atopic features. Previous studies have suggested that this may be so (Jewel & Truelove, 1972). Methods Three hundred patients with ulcerative colitis and 200 with Crohn's disease were given questionnaires and asked whether they had ever suffered from asthma, hay fever, allergic rhinitis or eczema. Asthma was defined as 'breathlessness and wheezing'; allergic rhinitis was likened to 'hay fever with features of recurrent sneezing and a watery nasal discharge' and eczema was described as 'patches of dry, red, inflamed, itchy skin'. Questions were also asked about skin reactions to drugs, soaps, powders, plasters and tapes to establish cases of contact dermatitis and drug allergies which might have been confused with atopic eczema. A family history of atopic illness amongst parents or siblings of the patients was also recorded. Correspondence: Dr J. Rhodes, Consultant Gastroenterologist, University Hospital of Wales Heath Park, Cardiff CF4 4XW. 0009-9090/79/0500-0221 $02.00
© 1979 Blackwell Scientific Publications
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S. M. Pugh et al.
One hundred and fifty-five of the 300 patients with ulcerative colitis attended a clinic for infiammatory bowel disease in Cardiff and had either proctitis or proctocolitis. The diagnosis in these patients was supported by either histological or radiological evidence. The remaining 145 patients came from South Wales or Nottingham and were members of the lleostomy Association, having had a total procto-colectomy with subsequent pathological confirmation of the disease. The 200 patients with Crohn's disease were contacted in a special clinic for treatment of this condition; the diagnosis had also been made on radiological or histological criteria. Controls were obtained by using the patient's spouse in the case of 139 patients with colitis and 115 patients with Crohn's disease, while the remaining patients were matched for age and sex with patients attending a dental outpatient department. Results In ulcerative colitis a history of each atopic feature was obtained in twice as many patients as controls, whereas in Crohn's disease the prevalence of asthma, hay fever and allergic rhinitis did not differ from controls (Table 1). Eczema was more common Table 1. The frequency of atopic features in patients with ulcerative colitis and Crohn's disease compared with controls. The results were analysed by i^ test and are presented as percentages Ulcerative colitis (n = 300)
Asthma Hay fever Allergic rhinitis Eczema Any atopic feature Positive family history
Crohn's disease (n = 200)
Cases
Controls
P value
Cases
Controls
P value
93 15 0 193 21 0 383 290
50 7-3 110 80 180 16-6
Atopic disease in ulcerative colitis and Crohn's disease
S. M. PUGH, J. RHODES, J. F. MAYBERRY, D. L. ROBERTS, R. V. HEATLEY and R. G. NEWCOMBE Department of Gastroenterology and University Department of Medical Statistics, University Hospital of Wales, Cardiff (Received 4 December 1978; accepted for publication 5 December 1978J
Summary Three hundred patients with ulcerative colitis, 200 with Crohn's disease and matched control subjects completed questionnaires about atopic disease. They were asked whether they had ever suffered from asthma, hay fever, allergic rhinitis or eczema; in ulcerative colitis all of these features occurred with twice the frequency, but in Crohn's disease only eczema was more common than in controls. Introduction Although the pathogenesis of both ulcerative colitis and Crohn's disease is poorly understood some recent work would suggest that a hypersensitivity reaction involving IgE may play some part in ulcerative colitis (Heatley et al., 1975b; Mani et al., 1976; Dronfield & Langman, 1977). If this is true one would anticipate that patients with colitis may suffer from atopic illnesses more often than a control population. We have questioned patients with ulcerative colitis and Crohn's disease to determine whether they had an increased prevalence of atopic features. Previous studies have suggested that this may be so (Jewel & Truelove, 1972). Methods Three hundred patients with ulcerative colitis and 200 with Crohn's disease were given questionnaires and asked whether they had ever suffered from asthma, hay fever, allergic rhinitis or eczema. Asthma was defined as 'breathlessness and wheezing'; allergic rhinitis was likened to 'hay fever with features of recurrent sneezing and a watery nasal discharge' and eczema was described as 'patches of dry, red, inflamed, itchy skin'. Questions were also asked about skin reactions to drugs, soaps, powders, plasters and tapes to establish cases of contact dermatitis and drug allergies which might have been confused with atopic eczema. A family history of atopic illness amongst parents or siblings of the patients was also recorded. Correspondence: Dr J. Rhodes, Consultant Gastroenterologist, University Hospital of Wales Heath Park, Cardiff CF4 4XW. 0009-9090/79/0500-0221 $02.00
© 1979 Blackwell Scientific Publications
221
222
S. M. Pugh et al.
One hundred and fifty-five of the 300 patients with ulcerative colitis attended a clinic for infiammatory bowel disease in Cardiff and had either proctitis or proctocolitis. The diagnosis in these patients was supported by either histological or radiological evidence. The remaining 145 patients came from South Wales or Nottingham and were members of the lleostomy Association, having had a total procto-colectomy with subsequent pathological confirmation of the disease. The 200 patients with Crohn's disease were contacted in a special clinic for treatment of this condition; the diagnosis had also been made on radiological or histological criteria. Controls were obtained by using the patient's spouse in the case of 139 patients with colitis and 115 patients with Crohn's disease, while the remaining patients were matched for age and sex with patients attending a dental outpatient department. Results In ulcerative colitis a history of each atopic feature was obtained in twice as many patients as controls, whereas in Crohn's disease the prevalence of asthma, hay fever and allergic rhinitis did not differ from controls (Table 1). Eczema was more common Table 1. The frequency of atopic features in patients with ulcerative colitis and Crohn's disease compared with controls. The results were analysed by i^ test and are presented as percentages Ulcerative colitis (n = 300)
Asthma Hay fever Allergic rhinitis Eczema Any atopic feature Positive family history
Crohn's disease (n = 200)
Cases
Controls
P value
Cases
Controls
P value
93 15 0 193 21 0 383 290
50 7-3 110 80 180 16-6
