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

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 Crohn’s 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, Crohn’s disease, brain atrophy, white matter lesion, inflammatory bowel disease, magnetic resonance imaging (MRI)

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