Potential conflict of interest: Dr. Loftus has received research support from and has consulted for Abbott Labs, UCB Pharma and Janssen Biotech (fees to Mayo Clinic).
Neurologic complications in patients with inflammatory bowel disease: Increasing relevance in the era of biologics†
Article first published online: 2 MAY 2012
Copyright © 2012 Crohn's & Colitis Foundation of America, Inc.
Inflammatory Bowel Diseases
How to Cite
Singh, S., Kumar, N., Loftus, E. V. and Kane, S. V. (2012), Neurologic complications in patients with inflammatory bowel disease: Increasing relevance in the era of biologics. Inflamm Bowel Dis. doi: 10.1002/ibd.23011
- Article first published online: 2 MAY 2012
- Manuscript Accepted: 17 APR 2012
- Manuscript Received: 9 APR 2012
- neurological complications;
- extraintestinal manifestations
Extraintestinal manifestations of inflammatory bowel disease (IBD) can involve almost every organ system. Neurologic complications are not infrequent in patients with IBD, but are poorly recognized and underreported. Pathophysiologically, these may represent immune-mediated phenomenon, nonimmunologic complications due to micronutrient deficiencies, thromboembolism, or be medication-induced. Peripheral neuropathy is the most common neurologic complication of IBD and may be immune-mediated, or caused by therapy with anti-tumor necrosis factor-alpha (TNF-α) therapy or metronidazole. Multiple sclerosis occurs with a greater frequency in patients with IBD. Anti-TNF-α therapy can cause neurologic disease characterized by central demyelination that mimics multiple sclerosis. Hence, patients with a history of demyelinating diseases or with symptoms of polyneuropathy should be carefully evaluated before initiation of anti-TNF-α therapy. Natalizumab has been associated with fatal progressive multifocal leukoencephalopathy due to reactivation of JC virus, and occurs with greater frequency in patients with previous JC virus infection. Stroke secondary to venous or arterial thromboembolism can be seen in patients with active Crohn's disease. It is important for gastroenterologists to be aware of the neurologic complications in patients with IBD. Neurologic symptoms in these patients should be promptly evaluated. (Inflamm Bowel Dis 2012;)