PT -期刊文章盟林大卫盟Nagagopal Venna TI -不同寻常的年轻人多病灶的脑炎在偏远的背景下与硫唑嘌呤和英夫利昔单抗治疗溃疡性结肠炎临床,磁共振成像,神经病理学发现,玲珑steroid-responsive课程(P1.338) DP - 2017年4月18日TA -神经病学PG - P1.338 VI - 88 IP - 16补充4099 - //www.ez-admanager.com/content/88/16_Supplement/P1.338.short 4100 - //www.ez-admanager.com/content/88/16_Supplement/P1.338.full所以Neurology2017首页 4月18日;88 AB -目的:本病例报告的总体目标是,讨论,一些临床课程,神经影像学,neuropathologic发现异常steroid-responsive多病灶的脑炎与溃疡性结肠炎的年轻人曾在咪唑硫嘌呤和英夫利昔单抗。背景:炎症性肠病相关的周边和中枢神经系统症状,包括周围神经病变、脑血管疾病、脱髓鞘疾病、血管炎、淋巴增殖性疾病。Anti-TNF-alpha疗法也可以对神经系统有显著的影响,主要是作为中央髓鞘脱失。设计/方法:病例报告和文献的全面审查。结果:一个三十五岁的男人,之前在英夫利昔单抗和咪唑硫嘌呤为溃疡性结肠炎,所有免疫抑制药物进行结肠切除术后一年之前,面对多个离散和瞬态的失语症持久完全间隔12小时回到基线。主要支流的核磁共振大脑多病灶的显示,皮层下T2 hyperintensity疫源地,标志着大脑中动脉血管周的增强,和左额叶和颞叶leptomeningeal增强。腰椎穿刺显示淋巴细胞白血球增多70白细胞。广泛的系统性感染和自身免疫性检查是负面的。他接受了左额叶脑活检显示多病灶的血管周的肉芽肿性炎症过程。他被放在强的松的诊断和治疗试验。强的松为一个月,他没有进一步的临床发作。 Repeat MRI showed marked improvement in the T2 hyperintensities and resolution of the perivascular and leptomeningeal enhancement. Repeat lumbar puncture showed improvement in lymphocytic pleocytosis (14 white blood cells). He is currently being cross-tapered from prednisone to azathioprine and continues to do clinically well, with no further evidence of encephalitis.Conclusions: This case broadens the spectrum of neurologic disease associated with inflammatory bowel disease and TNF-alpha inhibitors. Encephalitis responsive to steroids should be considered in patients with inflammatory bowel disease exposed, even remotely, to anti-TNF-alpha biologics.Disclosure: Dr. Lin has nothing to disclose. Dr. Venna has nothing to disclose.