Neurological manifestations related to Crohn’s disease: a boon for the workforce

Nemati, Reza; Mehdizadeh, Somayeh; Salimipour, Hooman; Yaghoubi, Ehsan; Alipour, Zeinab; Tabib, Seyed Masoud; Assadi, Majid

doi:10.1093/gastro/gox034

Cited by 10 publications

(7 citation statements)

References 42 publications

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“…Bernstein et al described the association between female sex and ocular manifestation in IBD, but only iritis and uveitis were analyzed in that study ( 27 ). According to the results of our study (although not significant) and previous case reports of ION in IBD (in which all patients were male) ( 13 , 19 , 20 ), there may be a male predilection for ION development in IBD patients. Patients aged 30–39 years showed a significantly higher risk of ION development.…”

Section: Discussioncontrasting

confidence: 53%

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Association Between Ischemic Optic Neuropathy and Inflammatory Bowel Disease: A Population-Based Cohort Study in Taiwan

et al. 2021

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Background: Ischemic optic neuropathy (ION) is a possible extraintestinal manifestation (EIM) of inflammatory bowel disease (IBD). We investigate the relation between IBD and ION and possible risk factors associated with their incidence.Methods: Medical records were extracted from the National Health Insurance Research Database (NHIRD) from January 1, 2000, to December 31, 2013. The main outcome was ION development. Univariate and multivariate Cox regression analyses were performed.Results: We enrolled 22,540 individuals (4,508 with IBD, 18,032 without). The cumulative risk of developing ION was significantly greater for patients with IBD vs. patients without (Kaplan–Meier survival curve, p = 0.009; log-rank test). Seven (5%) and five (0.03%) patients developed ION in the IBD and control groups, respectively. Patients with IBD were significantly more likely to develop ION than those without IBD [adjusted hazard ratio (HR) = 4.135; 95% confidence interval: 1.312–11.246, p = 0.01]. Possible risk factors of ION development were age 30–39 years, diabetes mellitus (DM), hypertension, ischemic heart disease (IHD), atherosclerosis, and higher Charlson comorbidity index revised (CCI_R) value.Conclusion: Patients with IBD are at increased risk of subsequent ION development. Moreover, for patients with comorbidities, the risk of ION development is significantly higher in those with IBD than in those without.

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Section: Discussioncontrasting

confidence: 53%

“…Only a few case reports of the association between ION and CD have been reported. In addition, one of the cases had a personal history of common systemic risk factors related to NAION ( 13 , 19 , 20 ).…”

Section: Introductionmentioning

confidence: 99%

Association Between Ischemic Optic Neuropathy and Inflammatory Bowel Disease: A Population-Based Cohort Study in Taiwan

et al. 2021

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“…However, sporadic clinical cases were described, supporting the possible association between CD and polyneuropathy or vasculitis [23]. Polyneuropathy was reported in 0.9-3.6% of cases [24,25], while very few cases of CD were found in association with posterior reversible encephalopathy syndrome [26], anterior ischemic optic neuropathy [27,28] and myelopathy [29]. However, it is not yet clear whether the coexistence of these pathologies may represent a consequence of primary disease.…”

Section: Discussionmentioning

confidence: 99%

SOX-1 antibodies in a patient with Crohn’s disease: a case report

et al. 2022

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Background The anti-SOX-1 antibodies have been mainly associated with Lambert-Eaton Myasthenic Syndrome (LETMS) and Small-Cell Lung Cancer (SCLC). In this report, we describe the interesting case of a patient with serum anti-SOX-1 antibodies and Crohn’s Disease (CD) with ensuing neurological symptoms. Case presentation A Caucasian 67-year-old female was admitted to the Emergency Department with seizures, vertigo, emesis, nausea, postural instability and recurrent falls, over a period of 10 days. She had been affected by Crohn’s Disease since 1991. A CT scan failed to detect any ischemic or haemorrhagic lesion. A brain MRI revealed signs of leukoencephalopathy. Western blot analysis of her serum revealed a high titre of the onconeural antibody anti-SOX1, consistent with a neurological, cerebellar type, paraneoplastic syndrome. In spite of multiple efforts to unmask a possible underlying malignancy, no neoplastic lesion cropped up during hospitalization. Her clinical conditions progressively deteriorated, up to respiratory failure; a few days later she died, due to ensuing septic shock and Multiple Organ Failure. Conclusions Our experience may usher and reveal a new role of anti-neural antibodies, so far reckoned an early indicator of associated malignancy, suggesting that neurological syndromes associated with such antibodies may complicate also chronic Gastrointestinal (GI) diseases. As of now, testing for anti-neuronal antibodies appeared unnecessary within the diagnostic assessment of gastroenterological disorders, which may lead to overlooking incident neurologic autoimmune diseases. Further exploration of such research hypothesis in clinical grounds appears intriguing.

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“…Correlation coefficients with IgG were less statistically significant (0.2-0.6). This shows that IgA and IgM reactivity to LPS puts a patient with IBD at a greater risk for damage to the gut barrier, including disruption of zonulin/occludin, which can result in consequences and manifestations beyond the gastrointestinal tract [89].…”

Section: Discussionmentioning

confidence: 99%

Correlation between Antibodies to Bacterial Lipopolysaccharides and Barrier Proteins in Sera Positive for ASCA and ANCA

Vojdani

Vojdani²,

Herbert

et al. 2020

IJMS

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Individuals with intestinal barrier dysfunction are more prone to autoimmunity. Lipopolysaccharides (LPS) from gut bacteria have been shown to play a role in systemic inflammation, leading to the opening of the gut and blood-brain barrier (BBB). This study aims to measure antibodies against LPS and barrier proteins in samples positive for anti-Saccharomyces cerevisiae antibodies (ASCA) and anti-neutrophil cytoplasmic antibodies (ANCA) and compare them with these same antibodies in controls to determine whether a correlation between LPS and barrier proteins could be found. We obtained 94 ASCA- and 94 ANCA-positive blood samples, as well as 188 blood samples from healthy controls. Samples were assessed for antibodies to LPS, zonulin+occludin, S100B, and aquaporin-4 (AQP4). Results show significant elevation in antibodies in about 30% of ASCA- and ANCA-positive sera and demonstrate positive linear relationships between these antibodies. The findings suggest that individuals positive for ASCA and ANCA have increased odds of developing intestinal and BBB permeability compared to healthy subjects. The levels of LPS antibodies in both ASCA- and ANCA-positive and negative specimens showed from low and moderate to high correlation with antibodies to barrier proteins. This study shows that LPS, by damaging the gut and BBBs, contribute to the extra-intestinal manifestation of IBD. We conclude that IBD patients should be screened for LPS antibodies in an effort to detect or prevent possible barrier damage at the earliest stage possible to abrogate disease symptoms in IBS and associated disorders.

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Neurological manifestations related to Crohn’s disease: a boon for the workforce

Cited by 10 publications

References 42 publications

Association Between Ischemic Optic Neuropathy and Inflammatory Bowel Disease: A Population-Based Cohort Study in Taiwan

Association Between Ischemic Optic Neuropathy and Inflammatory Bowel Disease: A Population-Based Cohort Study in Taiwan

SOX-1 antibodies in a patient with Crohn’s disease: a case report

Correlation between Antibodies to Bacterial Lipopolysaccharides and Barrier Proteins in Sera Positive for ASCA and ANCA

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