Department of Ophthalmology, University Hospital of Ioannina, Ioannina, Greece.
J Crohns Colitis. 2009 Sep;3(3):212-4. doi: 10.1016/j.crohns.2009.04.001. Epub 2009 May 2.
A relationship between inflammatory bowel disease and multiple sclerosis is supported by a higher than expected coexistence of these diseases among families and individuals. A 32 year-old male with Crohn's disease of the terminal ileum diagnosed 4 years ago and HLA-B27 negative bilateral sacroiliitis diagnosed 2 years ago, was admitted in our hospital because of an acute episode of blurred vision. In addition the patient complained for urine incontinence. Before this admission the patient was administered methylprednisolone and Infliximab induction treatment. During admission the diagnosis of multiple sclerosis-associated bilateral optic neuritis was made and Infliximab was discontinued. The patient was started on therapy with interferon-beta for multiple sclerosis, prednizolone and azathioprine for Crohn's disease and oxybutynin hydrochloride for urine incontinence. After 8 weeks of Infliximab discontinuation patient recovered totally from optic neuritis. This is a rare case of totally reversible bilateral optic neuritis associated with multiple sclerosis in a patient with Crohn's disease and sacroiliitis receiving also Infliximab induction therapy.
炎症性肠病和多发性硬化症之间存在关联，这一点得到了家族和个体中这些疾病并存率高于预期的支持。一名 32 岁男性，4 年前被诊断为末端回肠炎克罗恩病，2 年前被诊断为 HLA-B27 阴性双侧骶髂关节炎，因视力模糊急性发作而入院。此外，患者还主诉有尿失禁。此次入院前，患者曾接受甲基强的松龙和英夫利昔单抗诱导治疗。入院时，诊断为多发性硬化症相关的双侧视神经炎，并停用英夫利昔单抗。患者开始接受多发性硬化症的干扰素-β治疗、克罗恩病的泼尼松龙和巯嘌呤以及盐酸奥昔布宁治疗尿失禁。停用英夫利昔单抗 8 周后，患者的视神经炎完全恢复。这是一例罕见的病例，在接受英夫利昔单抗诱导治疗的克罗恩病和骶髂关节炎患者中，同时发生完全可逆的多发性硬化症相关双侧视神经炎。
