Publication

Acute neurologic disorder in Crohn’s disease: A rare life-threatening complication

View document

Bibliographic Details
Summary:Clinicians should consider and approach inflammatory bowel diseases as a multisystemic disease. Though neurologic complications related to inflammatory bowel diseases are not rare, they are frequently underdiagnosed when compared with other organ complications. We report on a 40-year-old patient with severe Crohn’s disease and an acquired demyelinating polyneurophathy, malnourished, on biological therapy, who was admitted in our institution with an opportunistic infection (esophageal candidiasis). After successful treatment of infectious complication, he maintained unexplained dysphagia and gastric stasis requiring parenteral nutrition. Some weeks later he presented with ophthalmoplegia and cognitive impairment. A clinical diagnosis of Wernicke encephalopathy was suspected despite multivitamin infusion in standard doses. After high doses of intravenous thiamine, dysphagia and gastroparesis improved substantially. Wernicke encephalopathy is unusual in inflammatory bowel diseases patients and dysphagia is a very rare symptom of thiamine deficiency.
Main Authors:Machado,Joana
Other Authors:Ministro,Paula; Cancela,Eugénia; Araújo,Ricardo; Castanheira,António; Silva,Américo
Subject:Inflammatory bowel disease Crohn disease Thiamine deficiency Wernicke encephalopathy Deglutition disorders
Year:2014
Country:Portugal
Document type:report
Access type:open access
Associated institution:Fundação para a Ciência e Tecnologia
Language:English
Origin:SciELO Portugal
Description
Summary:Clinicians should consider and approach inflammatory bowel diseases as a multisystemic disease. Though neurologic complications related to inflammatory bowel diseases are not rare, they are frequently underdiagnosed when compared with other organ complications. We report on a 40-year-old patient with severe Crohn’s disease and an acquired demyelinating polyneurophathy, malnourished, on biological therapy, who was admitted in our institution with an opportunistic infection (esophageal candidiasis). After successful treatment of infectious complication, he maintained unexplained dysphagia and gastric stasis requiring parenteral nutrition. Some weeks later he presented with ophthalmoplegia and cognitive impairment. A clinical diagnosis of Wernicke encephalopathy was suspected despite multivitamin infusion in standard doses. After high doses of intravenous thiamine, dysphagia and gastroparesis improved substantially. Wernicke encephalopathy is unusual in inflammatory bowel diseases patients and dysphagia is a very rare symptom of thiamine deficiency.