Effect of cimetidine on enzyme actuation ....

Crohn's disease in married couples SIR,-We were interested to read of Crohn's disease occurring in two married couples (Gut 1985; 26: 1086) and would like to draw attention to a further example: Mr DH, born 1931, caucasian, presented in late 1960 with abdominal pain. A laparotomy was done and revealed Crohn's disease of the terminal ileum. In February 1966 a right hemicolectomy was carried out for a stricture of the terminal ileum and an abscess in the right iliac fossa. The gross appearances and histology were typical of Crohn's disease. Since then he has remained well apart from a mild recurrence of symptoms in 1980. Mrs SH, born 1933, caucasian, married Mr DH in 1954. A laparotomy was done in September 1965 for pain in the right iliac fossa. Just before surgery a mass had developed in this area. The terminal ileum and caecum were involved in Crohn's disease and a right hemicolectomy undertaken, after which she made a straightforward recovery. She had no further recurrence of this condition but subsequently developed a carcinoma of the breast and died in March 1985 of disseminated malignancy. Crohn's disease in both these patients followed a remarkably benign course and neither had a discharge from a sinus or fistula unlike in the report of Rhodes et dl. This is the fifth example and according to Rhodes and coworkers the p value for five or more couples=0.019-that is, significant. There may well be further examples still to be reported. Whether all this has any bearing on the aetiology of Crohn's disease remains to be determined.