Refractory Crohn's disease complicated with Guillain-Barré syndrome:A case report  

作　　者：A-Niu Liu Jia-Yi Yang Xing-Yu Chen Shan-Shan Wu Se-Niu Ji Zhi Shu-Mei Zheng 

机构地区：[1]Department of Gastroenterology and Hepatology,Chengdu Medical College,Chengdu 610500,Sichuan Province,China [2]Department of Gastroenterology and Hepatology,The General Hospital of Western Theater Command,Chengdu 610083,Sichuan Province,China [3]Department of Radiology,Wuxi People’s Hospital,Nanjing Medical University,Nanjing 214023,Jiangsu Province,China

出　　处：《World Journal of Clinical Cases》2025年第18期94-100,共7页世界临床病例杂志(英文)

摘　　要：BACKGROUND Inflammatory bowel disease(IBD)comprises a group of chronic inflammatory gastrointestinal disorders,including Crohn's disease(CD)and ulcerative colitis,with uncertain etiologies.The natural course of IBD can be accompanied by extraintestinal manifestations involving the skin,mucous membranes,musculo-skeletal structures,eyes,cardiovascular system and nervous system.Guillain-Barrésyndrome(GBS)is a type of peripheral neuropathy.However,the etiology and pathogenesis of IBD combined with GBS are unclear,and only a few clinical cases have been reported.Here,we report a case of refractory CD complicated by GBS and review the previous literature to improve the understanding of these diseases.A 34-year-old man had a 9-year history of refractory CD.He became unres-ponsive to multiple drugs and experienced recurrent intestinal fistulas.After several abdominal surgeries and treatment with ustekinumab,he achieved clinical remission.Unfortunately,he developed GBS during maintenance treatment with ustekinumab.According to previous reports,in some patients with IBD combined with GBS,GBS may be a comorbidity,an extraintestinal manifestation of IBD,or an adverse reaction to IBD therapeutic drugs.After a comprehensive evaluation,we suspected that GBS might have been a comorbidity in this patient.To avoid fatal disease relapse after medication discontinuation,we concluded that ustekinumab should not be withdrawn.On the basis of a joint decision between doctors and the patient,we decided to continue maintenance treatment with ustekinumab along with intravenous immunoglobulin,dexamethasone and traditional Chinese medicine acupuncture,which resulted in a steady improvement in his GBS symptoms and sustained remission of CD.CONCLUSION When IBD is complicated by a neurological disease,it is first necessary to analyze the patient's condition and then choose the corresponding treatment strategy.If the neurological disease is a specific comorbidity,treatment of both IBD and the comorbid disease should be considered.For IBD patien

关 键 词：Inflammatory bowel disease Crohn's disease Ulcerative colitis Guillain-Barrésyndrome Biological agents Case report 

分 类 号：R57[医药卫生—消化系统]