Multiple sclerosis and HLA-B27 negative sacroiliitis in a Crohn’s disease patient

Abstract

SUMMARY
A relationship between inflammatory bowel disease and MS
is supported by a higher than expected coexistence of these
diseases among families and individuals.
A 32 year-old male with Crohn’s disease of the terminal
ileum diagnosed 4 years earlier and HLA-B27 bilateral
sacroiliitis diagnosed two years earlier, was admitted to our
hospital because of an acute episode of blurred vision. In
addition the patient complained of urine incontinence.
Before this admission the patient had been elsewhere
administered three doses of Remicade and 16mg of methylprednisolone
p.os. During admission the diagnosis of
multiple sclerosis was made (MRI and IgG Index) and
Remicade was discontinued.
The patient was started on therapy with interferon-beta for
MS, oxybutynin hydrochloride (10mg/day) for urine incontinence,
prednizolone (10mg/day), methotrexate (10mg/week)
and azathioprine (100mg/day) for Crohn’s disease and is
now in excellent clinical status.
To the best of our knowledge this is one of the very rare
cases of Crohn’s disease with HLA-B27 negative sacroiliitis
preceding multiple sclerosis diagnosis.
Key words: Crohn’s disease, inflammatory bowel disease,
ulcerative colitis, multiple sclerosis, Remicade