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.

Keywords:

• Crohn´s disease
• demyelinating disease
• Guillain–Barré syndrome
• anti-TNF-α
• adalimumab

Disclosure statement

The authors report no conflicts of interests. The authors alone are responsible for the content and writing of this article.

Ethics approval

The study was reviewed and approved by the Federal University of Minas Gerais Institutional Review Board.

Informed consent

Patient provided informed written consent prior to case publication.

Funding

This study received funds from Federal University of Minas Gerais.