A Case-Control study of the prevalence of neurological diseases in inflammatory bowel disease (IBD)

Abstract

Neurological diseases are common in inflammatory bowel disease (IBD) patients, but their exact prevalence is unknown. Method: We prospectively evaluated the presence of neurological disorders in 121 patients with IBD [51 with Crohn's disease (CD) and 70 with ulcerative colitis (UC)] and 50 controls (gastritis and dyspepsia) over 3 years. Results: Our standard neurological evaluation (that included electrodiagnostic testing) revealed that CD patients were 7.4 times more likely to develop large-fiber neuropathy than controls (p = 0.045), 7.1 times more likely to develop any type of neuromuscular condition (p = 0.001) and 5.1 times more likely to develop autonomic complaints (p = 0.027). UC patients were 5 times more likely to develop large-fiber neuropathy (p = 0.027) and 3.1 times more likely to develop any type of neuromuscular condition (p = 0.015). Conclusion: In summary, this is the first study to prospectively establish that both CD and UC patients are more prone to neuromuscular diseases than patients with gastritis and dyspepsia.Keywords: Chron's disease, inflammatory bowel disease, peripheral neuropathy, small fiber neuropathy, ulcerative colitis. RESUMO Doenças neurológicas são comuns em pacientes com doença inflamatória intestinal (DII), mas sua prevalência exata é desconhecida. Métodos: Nós estudamos prospectivamente a presença de distúrbios neurológicos em 121 pacientes com DII [51 com doença de Crohn (DC) e 70 com colite ulcerativa (RCU)] e 50 controles (gastrite e dispepsia) ao longo de 3 anos. Resultados: A avaliação neurológica padronizada (que incluiu testes eletrodiagnósticos) demonstrou que pacientes com DC foram 7,4 vezes mais propensos a desenvolver neuropatias de fibras grossas do que os controles (p = 0,045), 7,1 vezes mais propensos a desenvolver qualquer tipo de condição neuromuscular (p = 0,001) e 5,1 vezes mais propensos a desenvolver queixas autonômicas (p = 0,027). Pacientes com RCU foram 5 vezes mais propensos de desenvolver neuropatia de fibras grossas (p = 0,027) e 3,1 vezes mais propensos a desenvolver qualquer tipo de condição neuromuscular (p = 0,015). Conclusão: Em resumo, este é o primeiro estudo prospectivo a estabelecer que os pacientes tanto com DC quanto de RCU são mais propensos a doenças neuromusculares do que os pacientes com gastrite e dispepsia.Palavras-chave: doença de Crohn, doença inflamatória intestinal, neuropatia periférica, neuropatia de fibras grossas, colite ulcerativa.

How We Treat Autoimmune Small Fiber Polyneuropathy with Immunoglobulin Therapy

“…In other patients, it may occur in the context of systemic autoimmune disease [3,4], and autonomic neuropathy may be the initial manifestation of Sjogren syndrome [5] or the antiphospholipid syndrome [6], which may coexist. Dysautonomia may also occur in association with most other autoimmune diseases, including some cases of Hashimoto thyroiditis [4], rheumatoid arthritis, [7] spondyloarthropathy [8], lupus [9], systemic sclerosis [10], celiac disease [11], inflammatory bowel disease [12], myasthenia gravis [13], and multiple sclerosis [1]. Indeed, it has been hypothesized that autonomic dysregulation may be involved in the etiopathogenesis of systemic autoimmunity as a result of the complex interactions between the immune system and the autonomic nervous system [14].…”

Intoxication accidentelle par dispositif transdermique de nicotine : à propos d’un cas pédiatrique

“…This may be true in children, although supportive prospective data are lacking. However, we and others have reported that neurological diseases are not uncommon in adult IBD, including with a recently published prospective study [2][3][4]. Second, they state that MG is rare in IBD, yet that MG appears to be more common in IBD than in the normal population [5].…”

“…Les produits de substitutions représentent la deuxième cause d'intoxication par ingestion, après les cigarettes, et leur proportion augmente entre 0 et 5 ans [1]. L'American Association of Poison Control Centers (AAPCC) [2] a recensé en 1995 près de 8000 cas d'intoxication dus aux produits tabagiques chez les enfants âgés de moins de 6 ans aux États-Unis, la plupart par ingestion de cigarettes. La sévérité des symptômes est corrélée à la quantité absorbée.…”

Peripheral neuropathy: An underreported neurologic manifestation of inflammatory bowel disease

“…Twenty percent of IBD patients showed large-fiber neuropathy; and twelve percent of CD and UC patients showed SFN demonstrated by skin wrinkling test and quantitative sensory testing. PN was the most common neurologic condition reported although the relation between the PN and vitamin B12 levels or the presence of diabetes mellitus and glucose intolerance were not addressed [36,37]. Patients with UC and CD were enrolled as control group in a study undertaken to know the prevalence of PN in patients with celiac disease in a US population.…”