Demyelination-like syndrome in Crohn's disease after infliximab therapy

An 18-year-old female patient with Crohn's disease involving the ileum and colon developed ankylosing spondylitis. After treatment of her spondylitis with multiple infliximab infusions, new onset of neurological symptoms developed, accompanied by detection of an abnormal white matter signal change on magnetic resonance imaging examination. Although infliximab treatment was terminated, the neurological symptoms and the magnetic resonance imaging changes persisted. Development of new neuropsychiatric changes in Crohn's disease should be thoroughly evaluated to exclude a concomitant demyelinating process. Infliximab infusions should be terminated if demyelination is suspected.