Abstract

MACHADO, Joana et al. Acute neurologic disorder in Crohn’s disease: A rare life-threatening complication. J Port Gastrenterol. [online]. 2014, vol.21, n.1, pp.31-34. ISSN 0872-8178.  https://doi.org/10.1016/j.jpg.2013.10.006.

Clinicians should consider and approach inflammatory bowel diseases as a multisystemic disease. Though neurologic complications related to inflammatory bowel diseases are not rare, they are frequently underdiagnosed when compared with other organ complications. We report on a 40-year-old patient with severe Crohn’s disease and an acquired demyelinating polyneurophathy, malnourished, on biological therapy, who was admitted in our institution with an opportunistic infection (esophageal candidiasis). After successful treatment of infectious complication, he maintained unexplained dysphagia and gastric stasis requiring parenteral nutrition. Some weeks later he presented with ophthalmoplegia and cognitive impairment. A clinical diagnosis of Wernicke encephalopathy was suspected despite multivitamin infusion in standard doses. After high doses of intravenous thiamine, dysphagia and gastroparesis improved substantially. Wernicke encephalopathy is unusual in inflammatory bowel diseases patients and dysphagia is a very rare symptom of thiamine deficiency.

Keywords : Inflammatory bowel disease; Crohn disease; Thiamine deficiency; Wernicke encephalopathy; Deglutition disorders.

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