Family history

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]


Overview

In medicine, a family history consists of information about disorders that a patient's direct blood relatives have suffered from. Genealogy typically includes very little of the medical history of the family, but the medical history could be considered a specific subset of the total history of a family.

Definition

A family history of coronary artery disease is defined as the presence of coronary artery disease in a first degree relative < 60 years of age.

Uses

Although often neglected,[1] many doctors glean information on family morbidity of particular diseases (e.g. cardiovascular diseases, autoimmune disorders, mental disorders, diabetes, cancer) to appreciate whether a person is at risk for developing similar problems. Use of a genogram can be helpful in a family history, which is in the format of a family tree.

Family histories may be imprecise because of various possible reasons:

  • Adoption or illegitimacy
  • Lack of contact between close relatives
  • Uncertainty about the relative's exact diagnosis

In complex situations, a family tree may be necessary to cover the necessary aspects.

Consequences

Not all positive family histories imply a genetic cause. If various members of the same family have been exposed to the same toxin, then they may develop similar symptoms without a genetic cause.

If a patient has a strong family history of a particular disorder (or group of disorders), this will generally lead to a lower threshold for investigating symptoms.

In diseases with a known hereditary component, many healthy people are now tested early to prevent the symptoms from developing. This has become accepted in cystic fibrosis, hemochromatosis and various other disorders.

References

  1. Rich EC, Burke W, Heaton CJ, Haga S, Pinsky L, Short MP, Acheson L. Reconsidering the family history in primary care. J Gen Intern Med 2004;19:273-80. PMID 15009784.


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