Publicação
Vasculites cerebrais na doença inflamatória intestinal
| Resumo: | Cerebral vasculitis has been considered as a possible complication of Inflammatory Bowel Disease (IBD), but the clinical presentation is nonspecific and definitive diagnosis requires brain biopsy. Methods: We performed a systematic review of cerebral vasculitis and IBD. Results: We identified 15 clinical cases, 8 had Crohn's disease (CD) and 7 had Ulcerative Colitis (CU). Neurological symptoms were focal in 7 patients (50,0%) and encephalopathy in 7 (50,0%), manifesting acutely in 6 (42,9%). Twelve patients (85,7%) already had a diagnosis of IBD and in 11 cases (91,7%) IBD was active or medicated. Only 4 cases (26,7%) were confirmed by brain biopsy, and 11 (73,3%) by imaging tests. Changes were seen in the CSF in 6 patients (66,7%) and inflammatory parameters in 9 (75,0%), vasculitis-associated auto-antibodies were present in 2 (16,7%), and other risk factors for cerebral thrombosis in 3 (30,0%). Six patients (42,9%) were treated with an immunosuppressant, and 12 (92,3%) recovered. Conclusion: The rarity of suspected cases and lack of confirmation of these, suggest that cerebral vasculitis should not be the first diagnosis hypothesis in brain neurological symptoms in IBD. |
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| Autores principais: | Pimenta, Rita Figueiredo |
| Assunto: | Vasculite do sistema nervoso central Doenças inflamatórias intestinais Neurologia |
| Ano: | 2014 |
| País: | Portugal |
| Tipo de documento: | dissertação de mestrado |
| Tipo de acesso: | acesso restrito |
| Instituição associada: | Universidade de Lisboa |
| Idioma: | português |
| Origem: | Repositório da Universidade de Lisboa |
| Resumo: | Cerebral vasculitis has been considered as a possible complication of Inflammatory Bowel Disease (IBD), but the clinical presentation is nonspecific and definitive diagnosis requires brain biopsy. Methods: We performed a systematic review of cerebral vasculitis and IBD. Results: We identified 15 clinical cases, 8 had Crohn's disease (CD) and 7 had Ulcerative Colitis (CU). Neurological symptoms were focal in 7 patients (50,0%) and encephalopathy in 7 (50,0%), manifesting acutely in 6 (42,9%). Twelve patients (85,7%) already had a diagnosis of IBD and in 11 cases (91,7%) IBD was active or medicated. Only 4 cases (26,7%) were confirmed by brain biopsy, and 11 (73,3%) by imaging tests. Changes were seen in the CSF in 6 patients (66,7%) and inflammatory parameters in 9 (75,0%), vasculitis-associated auto-antibodies were present in 2 (16,7%), and other risk factors for cerebral thrombosis in 3 (30,0%). Six patients (42,9%) were treated with an immunosuppressant, and 12 (92,3%) recovered. Conclusion: The rarity of suspected cases and lack of confirmation of these, suggest that cerebral vasculitis should not be the first diagnosis hypothesis in brain neurological symptoms in IBD. |
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