title: Guillain-Barré syndrome during adalimumab therapy for Crohn´s disease: coincidence or consequence?
abstract: We report the case of a 64-year-old patient diagnosed with extensive ileal Crohn´s disease who developed Guillain-Barré syndrome after starting biological therapy with adalimumab. Neurologic involvement associated with inflammatory bowel diseases is recognized as an extra-intestinal manifestation. After the breakthrough of antitumor necrosis factor alpha (anti-TNF-α) agents, an increasing number of cases of acute inflammatory demyelinating polyneuropathies have been reported; however, only one case has been described in a patient with Crohn´s disease. Although a causal relationship between Guillain-Barré syndrome and TNF-α antagonist therapy cannot be proven, this report emphasizes the need to monitor for neurologic signs and symptoms in patients with inflammatory bowel diseases, with or without biological therapy, to avoid severe and irreversible complications associated with demyelinating diseases.
authors.affiliation: a Instituto Alfa de Gastroenterologia , Hospital das Clínicas da Universidade Federal de Minas Gerais , Belo Horizonte , Brazil.
authors.forename: Guilherme Grossi Lopes
authors.initials: GG
authors.lastname: Cançado
authors.affiliation: a Instituto Alfa de Gastroenterologia , Hospital das Clínicas da Universidade Federal de Minas Gerais , Belo Horizonte , Brazil.
authors.forename: Eduardo Garcia
authors.initials: EG
authors.lastname: Vilela
mesh_terms: D000005:Abdomen / Q000000981:diagnostic imaging; D000068879:Adalimumab / Q000009:adverse effects / Q000627:therapeutic use*; D001691:Biological Therapy / Q000009:adverse effects; D003424:Crohn Disease / Q000150:complications* / Q000628:therapy*; D020275:Guillain-Barre Syndrome / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
chemical_list: D014409:Tumor Necrosis Factor-alpha; D000068879:Adalimumab
keywords: Crohn´s disease; Guillain–Barré syndrome; adalimumab; anti-TNF-α; demyelinating disease