Polyneuropathy: an unusual extraintestinal manifestation of Crohn's disease.
Among the extraintestinal complications of Crohn's disease, neuropathy seems to be rare, and is only exceptionally reported in the literature. The authors present the report of a patient followed over a 12-year period who developed polyneuropathy with a parallel course to Crohn's disease. There was no evidence of any other underlying condition. On one occasion, the patient developed a cutaneous vasculitis with fibrinoid deposits in the vessels. The search for circulating immune complexes was positive. The authors demonstrated increased intestinal permeability using the 51chromium-labeled ethylenediaminetetra-acetate (51Cr-EDTA) test. Ultrastructural study of a biopsy of the superficial peroneal nerve disclosed a marked denervation process. Therapeutic plasmapheresis were performed, improving the neurologic symptoms. Vasculitis with circulating immune complexes is suggested as a possible mechanism in view of the occurrence of cutaneous vasculitis, increased intestinal permeability, and plasma exchange efficiency.
Humbert
P
P
Department of Internal Medicine, Centre Hospitalier Universitaire Jean Minjoz, Besancon, France.
Monnier
G
G
Billerey
C
C
Birgen
C
C
Dupond
J L
JL
D001706:Biopsy; D003424:Crohn Disease / Q000150:complications* / Q000503:physiopathology; D004576:Electromyography; D006801:Humans; D008297:Male; D008875:Middle Aged; D009132:Muscles / Q000473:pathology; D010523:Peripheral Nervous System Diseases / Q000150:complications* / Q000503:physiopathology