J Child Neurol. 2014 Sep;29(9):NP78-80. doi: 10.1177/0883073813503903. Epub 2013 Oct 03.

Guillain-Barré syndrome and Crohn disease: a case report.

Journal of child neurology

Hidehiko Yanagida, Keisuke Sugimoto, Akane Izu, Norihisa Wada, Naoki Sakata, Tsukasa Takemura

PMID: 24092893 DOI: 10.1177/0883073813503903

Abstract

Development of both Crohn disease and Guillain-Barré syndrome likely involves autoimmunity associated with excessive inflammatory cytokines. We treated a girl who developed Guillain-Barré syndrome during the course of Crohn disease. Although high-dose γ-globulin therapy administered initially for Guillain-Barré syndrome was ineffective, plasmapheresis ameliorated her acute neuropathic symptoms. Crohn disease was managed with Salazopyrin administration and enteral feeding. Chronic inflammation of the intestinal mucosa caused by Crohn disease can allow presentation of microbial intestinal antigens normally hidden from the immune system. Such presentation could incite an extraintestinal immune response on the basis of molecular mimicry, leading to activation of systemic autoimmunity against the nervous system. Accordingly, concurrence of Guillain-Barré syndrome and Crohn disease in our patient appeared to result from shared autoimmune mechanisms and systemic and local increases in cytokine concentrations. The patient also developed erythema nodosum and gall stones, relatively common complications of Crohn disease. However, Guillain-Barré syndrome is rare.

© The Author(s) 2013.

Keywords: Crohn disease; Guillain-Barré syndrome; extraintestinal complication

MeSH terms

• Child
• Crohn Disease / complications
• Crohn Disease / pathology
• Crohn Disease / physiopathology
• Crohn Disease / therapy
• Disease Progression
• Female
• Guillain-Barre Syndrome / complications
• Guillain-Barre Syndrome / pathology
• Guillain-Barre Syndrome / physiopathology
• Humans

Publication Types

• Case Reports
• Journal Article