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Brain demyelination in children with Crohn’s disease


Authors: A. Šuláková 1,2;  J. Horáček 3;  V. Doležilová 4;  O. Škopková 2
Authors‘ workplace: Katedra interních oborů, LF Ostravská univerzita, Ostrava vedoucí katedry MUDr. I. Valkovský 1;  Klinika dětského lékařství, FN Ostrava přednosta doc. MUDr. M. Hladík, Ph. D. 2;  Ústav patologické anatomie a soudního lékařství, LF Ostravská univerzita, Ostrava vedoucí katedry prof. MUDr. J. Mačák, CSc. 3;  Radiodiagnostický ústav, FN Ostrava přednosta MUDr. A. Jahodová 4
Published in: Čes-slov Pediat 2012; 67 (Suppl 1): 29-35.
Category: Original Papers

Overview

Background:
Crohn’s disease and ulcerative colitis are inflammatory bowel disease (IBD) with chronic relapsing course and multifactorial etiology. IBDs are usually considered to be a systemic illness, often involve other organs (6–47 %, principally skin, eyes, joints and hepatobiliary system). There are only sporadic reports of neurological manifestation in IBD patients (3–19 %, cerebrovascular disease, polyneuropathy, myopathy, and demyelinating disease including multiple sclerosis) and MRI studies have shown clinical non apparent cerebral demyelination in these patients. The cause of demyelination in IBD patients has not been explained yet.

Aim:
To draw attention to less common potentially serious illness of central nervous system in patients with IBD.

Methods:
We report on several cases of children with focal brain demyelination at the time of diagnosis Crohn’s disease and with neurological symptomatology in two of them. Two patients were treated by infliximab without worsening neurological symptomatology. No of them has developed demyelinating disease.

Conclusion:
Neurological disorders in IBD patients are less common but potentially severe. We point out the importance of an increased awareness for this problem, particularly in anti- TNFα-era.

Key words:
demyelination, Crohn’s disease, extraintestinal manifestation, anti-TNFα


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Labels
Neonatology Paediatrics General practitioner for children and adolescents
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