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一名克罗恩病患者的韦尼克脑病:病例报告

Wernicke's Encephalopathy in a Patient With Crohn's Disease: A Case Report.

作者信息

Adamou Fatima, Darkaoui Doua, Koulali Hajar, Ismaili Zahi, Kharrasse Ghizlane

机构信息

Hepato-Gastroenterology, Mohammed VI University Hospital, Oujda, MAR.

Digestive Diseases Research Laboratory (DSRL), Faculty of Medicine and Pharmacy, Mohammed First University, Oujda, MAR.

出版信息

Cureus. 2023 Sep 23;15(9):e45810. doi: 10.7759/cureus.45810. eCollection 2023 Sep.

Abstract

The inflammatory bowel diseases (IBD), including Crohn's disease (CD) and ulcerative colitis (UC), are chronic inflammatory disorders of the intestine. Both are associated with intestinal and extra-intestinal manifestations (EIM). EIM are usually related to intestinal disease activity and may precede or develop concurrently with intestinal symptoms. Although they are well documented, the association of CD with neurological and neuromuscular involvement is rare and controversial, with sporadic and contradictory data regarding its prevalence and spectrum. Neurological involvement can affect the central or peripheral nervous system, with thrombotic events being the most frequent complication. Wernicke's encephalopathy (WE) is one of the neurological complications that occurs in the general population with a clinical prevalence ranging from 0.04% to 0.13%. Although no specific data exists for IBD patients, it is imperative for clinicians to be vigilant and consider the possibility of this condition even with mild neurological symptoms and to administer vitamin B1 promptly before attempting any biological assessment. Timely treatment is essential to avoid irreversible damage or even the death of the patient. We report herein a challenging case of WE in CD and we discuss the literature.

摘要

炎症性肠病(IBD),包括克罗恩病(CD)和溃疡性结肠炎(UC),是肠道的慢性炎症性疾病。两者均与肠道及肠外表现(EIM)相关。EIM通常与肠道疾病活动相关,可能在肠道症状之前出现或与肠道症状同时发生。尽管有充分的文献记载,但CD与神经及神经肌肉受累的关联罕见且存在争议,关于其患病率和范围的数据零散且相互矛盾。神经受累可影响中枢或周围神经系统,血栓形成事件是最常见的并发症。韦尼克脑病(WE)是一般人群中发生的神经并发症之一,临床患病率为0.04%至0.13%。虽然IBD患者没有具体数据,但临床医生必须保持警惕,即使患者有轻微神经症状也要考虑到这种情况的可能性,并在进行任何生物学评估之前及时给予维生素B1。及时治疗对于避免患者不可逆转的损害甚至死亡至关重要。我们在此报告一例CD患者发生的具有挑战性的WE病例,并对相关文献进行讨论。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a7ac/10591271/6bae63260c8c/cureus-0015-00000045810-i01.jpg

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