Benjamin Alexandre1, Yves Vandermeeren2, Olivier Dewit3, Tom Moreels3, Nanne de Boer4, Anjan Dhar5, Chris Ziady6, Ariella Bar-Gil Shitrit7, Flavio Steinwurz8, Njegica Jojic9, Giuseppe Costantino10, Benoit Bihin11, Jean-François Rahier12, Konstantinos H Katsanos13. 1. Department of Internal Medicine and Hepato-gastroenterology Unit, Notre-Dame de Grâce Hospital, Gosselies, Belgium Benjamin.alexandre@gmail.com. 2. Department of Neurology, Université Catholique de Louvain, Yvoir, Belgium. 3. Department of Gastroenterology, Université Catholique de Louvain, St-Luc Hospital, Brussels, Belgium. 4. Department of Gastroenterology and Hepatology, VU University Medical Centre, Amsterdam, The Netherlands. 5. Darlington Memorial and Bishop Auckland Hospitals, County Durham and Darlington NHS Foundation Trust, Durham, UK. 6. Department of Gastroenterology, Kloof Hospital, Pretoria, South Africa. 7. Department of Gastroenterology, Shaare-Zedek Medical Center, Jerusalem, Israel. 8. Department of Gastroenterology, Hospital Israelita Albert Einstein, Sao Paolo, Brazil. 9. Department of Gastroenterology, University Hospital Zvezdara, Belgrade, Serbia. 10. Department of Internal Medicine and Medical Therapy University of Messina, Messina, Italy. 11. Scientific Support Unit, Université Catholique de Louvain, Yvoir, Belgium. 12. Department of Gastroenterology, Université Catholique de Louvain, Yvoir, Belgium. 13. Division of Gastroenterology, University Hospital of Ioannina, Ioannina, Greece.
Abstract
BACKGROUND AND AIMS: Acute optic neuritis [ON] is an inflammatory condition affecting the optic nerve. Clinicians should suspect optic neuritis in cases of painful and rapidly progressive loss of central visual field. This condition may be associated with a multitude of diseases, and mostly with multiple sclerosis [MS] where it may present as an initial symptom. The literature reports that optic neuritis and MS occur in patients with inflammatory bowel disease [IBD] before and after the era of anti-tumour necrosis factor-α [TNFα] drugs. At the present moment, there is little consensus for managing this complication, currently treated with corticosteroids and discontinuation of the causative agents. METHODS: We collected cases through a retrospective multicentre European Crohn's and Colitis Organisation CONFER [COllaborative Network For Exceptionally Rare case reports] project. We also performed a comprehensive retrospective search of the available literature on this topic. RESULTS: We report herein 12 new cases of ON, including 10 under anti-TNF therapy, collected through the CONFER project. We also compare characteristics of ON associated or not with anti-TNFα agents. CONCLUSIONS: The exceptional and current observation of distant family history of MS in 17% of our patients who developed ON, despite the small number and the lack of a control arm, might be an important signal that should be taken into account in our therapeutic strategies in the future.
BACKGROUND AND AIMS: Acute optic neuritis [ON] is an inflammatory condition affecting the optic nerve. Clinicians should suspect optic neuritis in cases of painful and rapidly progressive loss of central visual field. This condition may be associated with a multitude of diseases, and mostly with multiple sclerosis [MS] where it may present as an initial symptom. The literature reports that optic neuritis and MS occur in patients with inflammatory bowel disease [IBD] before and after the era of anti-tumour necrosis factor-α [TNFα] drugs. At the present moment, there is little consensus for managing this complication, currently treated with corticosteroids and discontinuation of the causative agents. METHODS: We collected cases through a retrospective multicentre European Crohn's and Colitis Organisation CONFER [COllaborative Network For Exceptionally Rare case reports] project. We also performed a comprehensive retrospective search of the available literature on this topic. RESULTS: We report herein 12 new cases of ON, including 10 under anti-TNF therapy, collected through the CONFER project. We also compare characteristics of ON associated or not with anti-TNFα agents. CONCLUSIONS: The exceptional and current observation of distant family history of MS in 17% of our patients who developed ON, despite the small number and the lack of a control arm, might be an important signal that should be taken into account in our therapeutic strategies in the future.
Authors: K Kimura; S F Hunter; M S Thollander; E V Loftus; L J Melton; P C O'Brien; M Rodriguez; S F Phillips Journal: Mayo Clin Proc Date: 2000-08 Impact factor: 7.616