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接受英夫利昔单抗治疗的克罗恩病患者的慢性炎症性脱髓鞘性多发性神经病

Chronic Inflammatory Demyelinating Polyneuropathy in Patients With Crohn's Disease on Infliximab Therapy.

作者信息

Almuntashri Fahad, Binyaseen Kenan, Alkhotani Amal

机构信息

Department of Medicine, Umm Al-Qura University, Faculty of Medicine, Mecca, SAU.

Neurology Department, King Abdullah Medical City, Mecca, SAU.

出版信息

Cureus. 2021 Oct 25;13(10):e19041. doi: 10.7759/cureus.19041. eCollection 2021 Oct.

Abstract

Crohn's disease (CD) is a chronic inflammatory disorder of the gastrointestinal tract that is frequently accompanied by systemic complications including peripheral neuropathies. Anti-tumor necrosis factor-alpha agents such as infliximab are an established treatment for immune-mediated diseases. However, they have been associated with adverse effects, including local reactions, infections, congestive heart failure, malignancies, and, rarely, they can cause neurological adverse effects on the central nervous system, as well as peripheral nervous system demyelination. Here, we report the case of an 80-year-old man with CD on infliximab therapy who presented with progressive weakness and numbness. A neurological examination and a nerve conduction study suggested chronic inflammatory demyelinating polyneuropathy (CIDP). The patient was started on oral corticosteroids and experienced transient improvement of his symptoms at the end of this course. Thus, CIDP could be one of the extraintestinal presentations of CD.

摘要

克罗恩病(CD)是一种胃肠道慢性炎症性疾病,常伴有包括周围神经病变在内的全身并发症。抗肿瘤坏死因子-α药物如英夫利昔单抗是治疗免疫介导疾病的常用药物。然而,它们也会带来不良反应,包括局部反应、感染、充血性心力衰竭、恶性肿瘤,而且很少见的是,它们会对中枢神经系统造成神经不良反应,以及导致周围神经系统脱髓鞘。在此,我们报告一例80岁接受英夫利昔单抗治疗的克罗恩病男性患者,该患者出现进行性肌无力和麻木。神经检查和神经传导研究提示为慢性炎症性脱髓鞘性多发性神经病(CIDP)。患者开始口服皮质类固醇,在此疗程结束时症状有短暂改善。因此,CIDP可能是克罗恩病的肠外表现之一。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/84b7/8612716/62dbd1105dbc/cureus-0013-00000019041-i01.jpg

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