Crohn disease and chronic inflammatory demyelinating polyneuropathy; a case report.

Abstract

Background: The neurological manifestations of Crohn's disease are rare, dominated by multiple mononeuropathies, peripheral neuropathies (PN) of axonal and demyelinating types, myopathies and the abnormalities of the white matter. In our study, we aimed to report electrophysiological follow-up of a patient with chronic polyradiculoneuritis associated with newly diagnosed active Crohn's disease.

Case: A 32-year-old male patient was admitted with the complaints of abdominal pain and diarrhea for three years and an ascending weakness of all four extremities since two years. On his medical history he did not have any other disease and none of the members of his family had similar complaints. The neurological examination revealed a weakness of the especially distal muscles (2-3/5) with areflexia, hypotonia and distal atrophia in all extremities. He also had a glove and stocking hypoestesia. Routine biochemical and hematological examination were in normal ranges except C-reactive protein. The analysis of the cerebrospinal fluid showed an albumino-cytological dissociation.

Conclusion: Our results suggest that peripheral neurological findings could be regarded as a possible extraintestinal manifestation of Crohn's disease. It is important to remember that inflammatory bowel diseases may be a reason for a newly diagnosed polyneuropathy (acute or chronic demyelinated polyneuropathy) and therefore detailed examinations are needed if the patients do not have the commonly observed reasons for the development of polyneuropathy and be careful in inflammatory disease patient to develop polyneuropathy.