Abstract

Anti-tumor necrosis factor alpha antibodies have been used with increasing frequency despite the number of reported adverse effects. Further new information is still emerging. Here we report the case of a 71-years-old patient affected by Crohn's disease and HCV-positive who developed Guillain–Barrè syndrome after four injections of fully human anti-tumor necrosis factor alpha antibodies (adalimumab). Indication for the treatment was severe clinical recurrence of Crohn's disease following intestinal resection. Guillain–Barrè syndrome was treated by intravenous immunoglobulins, and methylprednisolone and plasmapheresis were started with a progressive partial resolution of neurological symptoms. To date, Crohn's disease was maintained in clinical remission with low dose steroid therapy.

Highlights: ► An increased risk for developing demyelinating diseases has been reported in IBD patients. ► This is the first case of GBS developing in a IBD patient following ADA use. ► Patients receiving TNF-α antagonists should be monitored for neurologic signs and symptoms suggestive of demyelinating disease.

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