Taking a closer look into Crohn's disease and cerebral palsy

Inflammatory bowel disease (IBD), which includes Crohn's disease (CD), is a chronic, immune-mediated disease involving the gastrointestinal tract. Cerebral palsy (CP) has not been associated with IBD aside from a single previously published case series. In this study, we describe two cases of CD in patients with CP. Both patients had global developmental delay. They were also underweight and exclusively gastrostomy tube dependent for nutrition. By detailing their clinical courses, we illustrate the importance of becoming familiar with the extraintestinal manifestations of IBD. In the setting of developmental delay and its associated communication barriers, the evaluation of IBD might shift from assessing subjective symptoms to recognizing the subtle presentations of the disease, including anemia, weight loss, malnutrition, and failure to thrive. We also hypothesize that malnutrition and a change in the gastrointestinal microbiota associated exclusively with enteral nutrition may be linked to the development of CD in patients with CP. Overall, this study provides information for clinicians caring for patients with CP or developmental delay, and how to recognize extraintestinal manifestations of IBD.