Neurology Department, Hospital Universitario Central Asturias, Avda de Roma s/n, Oviedo, Asturias 33011, Spain.
Eur J Intern Med. 2015 Sep;26(7):468-75. doi: 10.1016/j.ejim.2015.07.013. Epub 2015 Jul 23.
One of the most frequent neurologic complications reported in inflammatory bowel disease population is peripheral neuropathy; however, clinical aspects of peripheral nerve damage are not well characterized. The aim of the review is to present the existing literature on peripheral neuropathy in inflammatory bowel disease patients.
A literature search identified the publications reporting on epidemiology, clinical features, underlying mechanisms and management of ulcerative colitis and Crohn's disease patients with peripheral nerve involvement.
The pathogenesis of peripheral nervous system damage in inflammatory bowel disease has yet to be elucidated, although it seems to be related to immune mechanisms; therefore, treatment with immunotherapy is recommended. In addition, peripheral neuropathy may appear as iatrogenic-related disorders associated with several drugs used in controlling inflammatory bowel disease activity; finally, peripheral neuropathy may also be caused by micronutrient deficiencies secondary to malabsorption-related disorders.
Although peripheral nervous nerve damage associated with inflammatory bowel disease is rarely reported, clinicians should be aware of the peripheral neuropathy clinical manifestations in order to recognize it and provide early treatment, which is crucial for preventing major neurologic morbidity. Heightened awareness is necessary for the successful management of these patients.
炎症性肠病患者最常报告的神经并发症之一是周围神经病;然而,周围神经损伤的临床特征尚未得到很好的描述。本综述的目的是介绍炎症性肠病患者周围神经病的现有文献。
通过文献检索,确定了报道溃疡性结肠炎和克罗恩病患者伴周围神经受累的流行病学、临床特征、潜在机制和治疗的出版物。
炎症性肠病患者的周围神经系统损伤的发病机制尚未阐明,尽管它似乎与免疫机制有关;因此,建议使用免疫疗法进行治疗。此外,周围神经病可能表现为与几种用于控制炎症性肠病活动的药物相关的医源性疾病;最后,周围神经病也可能是由于吸收不良相关疾病导致的微量营养素缺乏引起的。
尽管与炎症性肠病相关的周围神经损伤很少见,但临床医生应该了解周围神经病的临床表现,以便识别并提供早期治疗,这对预防主要神经发病率至关重要。提高认识对于这些患者的成功管理是必要的。