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Cerebral vascular events associated with ulcerative colitis in children
D L Keene1, M A Matzinger, P J Jacob
1Division of Pediatric Neurology, Department of Pediatrics, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada.
Insights
Cerebral vascular events are a rare complication of inflammatory bowel disease (IBD) exacerbations. This study describes three pediatric cases, highlighting the need for awareness of this serious neurological complication in IBD patients.
Area of Science:
- Neurology
- Gastroenterology
- Pediatrics
Background:
- Inflammatory bowel disease (IBD) is associated with extra-intestinal complications, including peripheral vascular thrombosis.
- Cerebral vascular events (CVEs) are rarely reported during acute IBD exacerbations.
Observation:
- Three pediatric patients (ages 5, 12, 13) presented with acute cerebrovascular events.
- Clinical and MRI findings confirmed the cerebrovascular events.
- These events coincided with acute exacerbations of their inflammatory bowel disease.
Findings:
- Hematologic and coagulation studies were largely unremarkable in these patients.
- Anemia was noted in the affected children.
- No evidence of systemic vasculitis was found.
Implications:
- This case series suggests a potential association between IBD exacerbations and CVEs in children.
- Increased clinical vigilance for neurological complications in pediatric IBD patients during flares is warranted.
- Further research is needed to elucidate the underlying mechanisms and optimal management strategies.
Abstract:
Although peripheral vascular thrombic events are recognized as a serious extra-intestinal complication of inflammatory bowel disease, the occurrence of cerebral vascular events in association with acute exacerbations of this group of diseases is rare. In this article, relevant literature is reviewed and three children, 5, 12, and 13 years of age, who presented with clinical and magnetic resonance imaging evidence of an acute cerebrovascular event in association with an acute exacerbation of their inflammatory bowel disease are described. Except for the presence of anemia, hematologic and coagulation studies were unremarkable, and a search for evidence of a systemic vasculitis proved negative.