Rare association of polyneuropathy and Crohn's disease: A clinicopathological study of 4 cases

Abstract

The purpose of this study is to investigate the clinical, electrophysiological and pathological features of neuropathy in patients with Crohn's disease. Biopsies were selected from over 700 sural nerve biopsies. The diagnosis of Crohn's disease was based on established clinicopathological criteria. Complete laboratory, clinical, electrophysiological and pathological studies were performed in all cases. Nerve biopsies of 4 patients were diagnosed as neuropathy and Crohn's disease. Distal symmetrical sensorimotor polyneuropathy was the pattern of neuropathy. The pathological features were mixed, demyelination with predominant axonal degeneration and a varying pattern of myelinated fiber loss. There were no vasculitic changes found. We conclude that patients with Crohn's disease are complicated frequently with polyneuropathy, and as remission depends on immunosuppressive therapy, it is important to recognise it in the early stage. The diagnosis of polyneuropathy is based on clinical and electrophysiological studies, but precise histology, immunohistochemistry and morphometric studies of the peripheral nerve biopsy may be decisive in establishing the diagnosis.