title: Acute disseminated encephalomyelitis in conjunction with inflammatory bowel disease.
abstract: Neurological complications in paediatric patients with inflammatory bowel disease (IBD) are rare. Most previous reports involve cerebral venous thrombosis, central nervous system vasculitis, or peripheral nerve inflammation. We report a child with active inflammatory bowel disease complicated by acute disseminated encephalomyelitis (ADEM). The child presented with acute neurological deficits following an exacerbation of colitis with evidence of lesions in the central nervous system white matter on magnetic resonance imaging. Ancillary investigations did not provide evidence of systemic infection, coagulation disorders, or vasculitis. In our case the colitis improved with immunosuppressive therapy, with a similar improvement in the white matter lesions showing almost complete resolution of the MR scan changes and no evidence of infarction. This case suggests that ADEM may be another extra intestinal manifestation of inflammatory bowel disease, probably associated with an autoimmune pathogenic mechanism.
authors.affiliation: Department of Paediatric Neurology, Royal Manchester Children's Hospital, Oxford Road, Manchester M13 9WL, UK. drmaziz@hotmail.com
authors.forename: Majid
authors.initials: M
authors.lastname: Aziz
authors.forename: Stavros
authors.initials: S
authors.lastname: Stivaros
authors.forename: Andrew
authors.initials: A
authors.lastname: Fagbemi
authors.forename: Grace
authors.initials: G
authors.lastname: Vassallo
mesh_terms: D002675:Child, Preschool; D004673:Encephalomyelitis, Acute Disseminated / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D015212:Inflammatory Bowel Diseases / Q000150:complications* / Q000188:drug therapy
chemical_list: D007166:Immunosuppressive Agents