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Incidence of multiple sclerosis in patiens with inflammatory bowel diseases (IBD)
Ročková, Petra ; Keil, Radan (advisor) ; Hep, Aleš (referee) ; Zádorová, Zdeňka (referee)
Ročková Summary Inflammatory bowel diseases (IBD) - Crohn's disease (CD) and ulcerative colitis (UC) are associated with various extraintestinal manifestations (EM). These manifestations may involve virtually any organ system. Neurological manifestations are not regarded as very common, but they are probably underdiagnosed. Patients with IBD have higher risk of developing multiple sclerosis (MS) regardless of therapy manner they use. There are quite a lot of publications describing relationship between developing multiple sclerosis and therapy with monoclonal antibody against tumor necrosis alpha (anti TNF-α). However, it remains to be shown whether anti-TNF-alpha itself causes MS or merely acts as a trigger, exacerbating preexisting subclinical CNS damage during chronic anti- TNF-α treatment. Majority of published cases support the second possibility. These results let us to define a hypothesis, that preselection of patients with IBD without any preclinical signs of demyelination before the initiation of anti TNF- a therapy may improve patient safety. The aim of our project was to develop neurological and magnetic resonance (MRI) screening of patients with IBD before anti TNF- α therapy initiation and subseqently exclusion of patients wth high risk of developing MS. The second aim was to follow up on the...
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Incidence of multiple sclerosis in patiens with inflammatory bowel diseases (IBD)
Ročková, Petra ; Keil, Radan (advisor) ; Hep, Aleš (referee) ; Zádorová, Zdeňka (referee)
Ročková Summary Inflammatory bowel diseases (IBD) - Crohn's disease (CD) and ulcerative colitis (UC) are associated with various extraintestinal manifestations (EM). These manifestations may involve virtually any organ system. Neurological manifestations are not regarded as very common, but they are probably underdiagnosed. Patients with IBD have higher risk of developing multiple sclerosis (MS) regardless of therapy manner they use. There are quite a lot of publications describing relationship between developing multiple sclerosis and therapy with monoclonal antibody against tumor necrosis alpha (anti TNF-α). However, it remains to be shown whether anti-TNF-alpha itself causes MS or merely acts as a trigger, exacerbating preexisting subclinical CNS damage during chronic anti- TNF-α treatment. Majority of published cases support the second possibility. These results let us to define a hypothesis, that preselection of patients with IBD without any preclinical signs of demyelination before the initiation of anti TNF- a therapy may improve patient safety. The aim of our project was to develop neurological and magnetic resonance (MRI) screening of patients with IBD before anti TNF- α therapy initiation and subseqently exclusion of patients wth high risk of developing MS. The second aim was to follow up on the...
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