Amnesia and brain atrophy with focal white matter lesion in a 30-year old male with Crohn’s disease

Abstract

SUMMARY
Central nervous system (CNS) manifestations in Crohn
disease (CD) have been well recognized over the years
have been regarded either as an extraintestinal disease
manifestation or as therapeutic side effects. Focal white
matter lesions in CD patients have been demonstrated using
magnetic resonance imaging (MRI).
A 30-year-old patient with small bowel Crohns disease
diagnosed 3 years ago came to the outpatient clinic complaining
of amnesia in relation to familiar names, for
last 2 years. Physical and neurologic examination were both
negative. Laboratory tests were within normal limits. Anticardiolipin
antibody, lupus anticoagulant, the widely known
list of risk factors for ischemic stroke, possible sources
emboli such as carotids and heart, deficiencies of protein
C, activated protein C, protein S and antithrombin III leading
to hypercoagulation were negative. Circulating immunocomplexes
and p-antineutrophil cytoplasm autoantibodies
(p-ANCA) were not detected.Neurological examination
revealed amnesia and brain magnetic resonance images
(MRI) showed cortical atrophy and a focal lesion in
paraventricular deep white matter of the left frontal lobe.
This is, to our knowledge the first report of a young
patient with amnesia and MRI demonstrable brain atrophy
with focal white matter lesion. Key words: amnesia, Crohns disease, brain atrophy, white
matter lesion, inflammatory bowel disease, magnetic resonance
imaging (MRI)