{"id":2073,"date":"2017-10-01T01:00:00","date_gmt":"2017-10-01T00:00:00","guid":{"rendered":"https:\/\/angh.net\/abstracts\/cas-clinique-une-complication-neurologique-inhabituelle-au-cours-dune-maladie-de-crohn-severe\/"},"modified":"2018-10-20T18:40:25","modified_gmt":"2018-10-20T16:40:25","slug":"cas-clinique-une-complication-neurologique-inhabituelle-au-cours-dune-maladie-de-crohn-severe","status":"publish","type":"post","link":"https:\/\/angh.net\/abstracts\/cas-clinique-une-complication-neurologique-inhabituelle-au-cours-dune-maladie-de-crohn-severe\/","title":{"rendered":"Cas clinique : Une complication neurologique inhabituelle au cours d&rsquo;une maladie de Crohn s\u00e9v\u00e8re"},"content":{"rendered":"<p><strong>2017<\/strong><\/p>\n<p><em>Mathias VIDON, Isabelle ROSA, Laurent COSTES, Alix PORTAL, Herv\u00e9 HAGEGE<br \/>\nCHI Cr\u00e9teil<\/em><\/p>\n<p><strong>Gastroent\u00e9rologie <\/strong>&#8211; \u00a02017-05-02 &#8211;\u00a0CC &#8211;<\/p>\n<p>________________________________<\/p>\n<p>Madame B., patiente de 43 ans, pr\u00e9sente une maladie de Crohn d\u00e9couverte en 2010, initialement trait\u00e9e par Cortancyl et Fivasa. En avril 2012 pr\u00e9sence d\u2019une fistule recto-vaginale et d\u2019une atteinte pan-colique et il\u00e9ale s\u00e9v\u00e8re associ\u00e9e \u00e0 une tuberculose pulmonaire probable trait\u00e9e par quadrith\u00e9rapie, puis bith\u00e9rapie pendant 1 an. En Janvier 2013 il est  instaur\u00e9 un traitement par Imurel et R\u00e9micade, jusqu\u2019en d\u00e9cembre 2014, date \u00e0 laquelle la patiente est perdue de vue.                                                                        Le 15 octobre 2016 : la patiente est hospitalis\u00e9e pour une pouss\u00e9e s\u00e9v\u00e8re il\u00e9o-pan-colique avec abc\u00e8s non collect\u00e9 au niveau du flanc gauche et une fistule recto-vaginale non abc\u00e9d\u00e9e. On d\u00e9bute une antibioth\u00e9rapie par Rocephine et Flagyl et une nutrition par modulen en exclusif, permettant une r\u00e9gression de l\u2019abc\u00e8s. Apr\u00e8s discussion, on d\u00e9cide de reprendre le traitement par anti TNF et on r\u00e9alise le 01\/11\/2016 une   perfusion de  Remsima 5mg\/kg, avec poursuite de la Rocephine et du Flagyl jusqu\u2019au 07\/11\/2016. Apr\u00e8s la 1\u00e8re perfusion de remsima la patiente se plaint  d\u2019une allodynie et d\u2019une hyperesth\u00e9sie douloureuse au niveau des mains et des pieds, non calm\u00e9e par les antalgiques classiques ou par le lyrica. Un EMG est pratiqu\u00e9 le 18\/11\/16 qui ne retrouve pas d\u2019anomalie aux quatre membres. Apr\u00e8s avis neurologique,  le 18\/11\/16 la  deuxi\u00e8me perfusion de remsima avec polaramine est administr\u00e9e. On reprend la bi-antibioth\u00e9rapie car le scanner de contr\u00f4le montre une r\u00e9cidive de l\u2019abc\u00e8s.<br \/>\nLe 27\/11\/16 la patiente pr\u00e9sente une aggravation de la dysesth\u00e9sie des membres inf\u00e9rieurs, puis une dysarthrie, une diplopie intermittente et un flou visuel. A l\u2019examen clinique la patiente pr\u00e9sente un syndrome c\u00e9rebelleux, une hypoesth\u00e9sie bilat\u00e9rale des membres inf\u00e9rieurs jusqu\u2019aux genoux, une atteinte de la sensibilit\u00e9 proprioceptive et thermo-algique et un d\u00e9ficit moteur aux quatre membres. L\u2019IRM c\u00e9r\u00e9brale du 05\/12\/2016 retrouve des hypersignaux FLAIR au niveau des noyaux dentel\u00e9s et sur l\u2019ensemble du tronc c\u00e9r\u00e9bral et de la substance blanche sous corticale des centres semi-ovales. Le fond d\u2019\u0153il montre \u0153d\u00e8me papillaire bilat\u00e9ral et une h\u00e9morragie inf\u00e9ro-maculaire. L\u2019EMG du 20\/12\/2016 montre une neuropathie axonale sensitivo-motrice \u00e0 vitesses lentes et longueur d\u00e9pendante avec abolition des PES aux membres inf\u00e9rieurs. La ponction lombaire montre une prot\u00e9inorachie \u00e0 0,186 g\/l, un liquide clair sans \u00e9l\u00e9ments.<br \/>\nQuel est votre diagnostic ?<\/p>\n","protected":false},"excerpt":{"rendered":"<p>2017 Mathias VIDON, Isabelle ROSA, Laurent COSTES, Alix PORTAL, Herv\u00e9 HAGEGE CHI Cr\u00e9teil Gastroent\u00e9rologie &#8211; \u00a02017-05-02 &#8211;\u00a0CC &#8211; ________________________________ Madame B., patiente de 43 ans, pr\u00e9sente une maladie de Crohn d\u00e9couverte en 2010, initialement trait\u00e9e par Cortancyl et Fivasa. En avril 2012 pr\u00e9sence d\u2019une fistule recto-vaginale et d\u2019une atteinte pan-colique et il\u00e9ale s\u00e9v\u00e8re associ\u00e9e \u00e0 [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[4],"tags":[28],"class_list":["post-2073","post","type-post","status-publish","format-standard","hentry","category-gastroenterologie","tag-28"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.2 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Cas clinique : Une complication neurologique inhabituelle au cours d&#039;une maladie de Crohn s\u00e9v\u00e8re - Abstracts des congr\u00e8s de l&#039;ANGH<\/title>\n<meta name=\"description\" content=\"ANGH R\u00e9sum\u00e9s congr\u00e8s H\u00e9patologie Gastroent\u00e9romogie Hepatology Gastroenterology Etudes cliniques Clinical study\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/angh.net\/abstracts\/cas-clinique-une-complication-neurologique-inhabituelle-au-cours-dune-maladie-de-crohn-severe\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Cas clinique : Une complication neurologique inhabituelle au cours d&#039;une maladie de Crohn s\u00e9v\u00e8re - Abstracts des congr\u00e8s de l&#039;ANGH\" \/>\n<meta property=\"og:description\" content=\"ANGH R\u00e9sum\u00e9s congr\u00e8s H\u00e9patologie Gastroent\u00e9romogie Hepatology Gastroenterology Etudes cliniques Clinical study\" \/>\n<meta property=\"og:url\" content=\"https:\/\/angh.net\/abstracts\/cas-clinique-une-complication-neurologique-inhabituelle-au-cours-dune-maladie-de-crohn-severe\/\" \/>\n<meta property=\"og:site_name\" content=\"Abstracts des congr\u00e8s de l&#039;ANGH\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/ANGH-2136322560030484\/\" \/>\n<meta property=\"article:published_time\" content=\"2017-10-01T00:00:00+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2018-10-20T16:40:25+00:00\" \/>\n<meta name=\"author\" content=\"abstracts\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"\u00c9crit par\" \/>\n\t<meta name=\"twitter:data1\" content=\"abstracts\" \/>\n\t<meta name=\"twitter:label2\" content=\"Dur\u00e9e de lecture estim\u00e9e\" \/>\n\t<meta name=\"twitter:data2\" content=\"2 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\/\/angh.net\/abstracts\/cas-clinique-une-complication-neurologique-inhabituelle-au-cours-dune-maladie-de-crohn-severe\/#article\",\"isPartOf\":{\"@id\":\"https:\/\/angh.net\/abstracts\/cas-clinique-une-complication-neurologique-inhabituelle-au-cours-dune-maladie-de-crohn-severe\/\"},\"author\":{\"name\":\"abstracts\",\"@id\":\"https:\/\/angh.net\/abstracts\/#\/schema\/person\/f532083854369dca4b9f509cfbad90e1\"},\"headline\":\"Cas clinique : Une complication neurologique inhabituelle au cours d&rsquo;une maladie de Crohn s\u00e9v\u00e8re\",\"datePublished\":\"2017-10-01T00:00:00+00:00\",\"dateModified\":\"2018-10-20T16:40:25+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\/\/angh.net\/abstracts\/cas-clinique-une-complication-neurologique-inhabituelle-au-cours-dune-maladie-de-crohn-severe\/\"},\"wordCount\":454,\"commentCount\":0,\"publisher\":{\"@id\":\"https:\/\/angh.net\/abstracts\/#organization\"},\"keywords\":[\"2017\"],\"articleSection\":[\"Gastroenterologie\"],\"inLanguage\":\"fr-FR\"},{\"@type\":\"WebPage\",\"@id\":\"https:\/\/angh.net\/abstracts\/cas-clinique-une-complication-neurologique-inhabituelle-au-cours-dune-maladie-de-crohn-severe\/\",\"url\":\"https:\/\/angh.net\/abstracts\/cas-clinique-une-complication-neurologique-inhabituelle-au-cours-dune-maladie-de-crohn-severe\/\",\"name\":\"Cas clinique : Une complication neurologique inhabituelle au cours d'une maladie de Crohn s\u00e9v\u00e8re - Abstracts des congr\u00e8s de l&#039;ANGH\",\"isPartOf\":{\"@id\":\"https:\/\/angh.net\/abstracts\/#website\"},\"datePublished\":\"2017-10-01T00:00:00+00:00\",\"dateModified\":\"2018-10-20T16:40:25+00:00\",\"description\":\"ANGH R\u00e9sum\u00e9s congr\u00e8s H\u00e9patologie Gastroent\u00e9romogie Hepatology Gastroenterology Etudes cliniques Clinical study\",\"breadcrumb\":{\"@id\":\"https:\/\/angh.net\/abstracts\/cas-clinique-une-complication-neurologique-inhabituelle-au-cours-dune-maladie-de-crohn-severe\/#breadcrumb\"},\"inLanguage\":\"fr-FR\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\/\/angh.net\/abstracts\/cas-clinique-une-complication-neurologique-inhabituelle-au-cours-dune-maladie-de-crohn-severe\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\/\/angh.net\/abstracts\/cas-clinique-une-complication-neurologique-inhabituelle-au-cours-dune-maladie-de-crohn-severe\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Accueil\",\"item\":\"https:\/\/angh.net\/abstracts\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Cas clinique : Une complication neurologique inhabituelle au cours d&rsquo;une maladie de Crohn s\u00e9v\u00e8re\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\/\/angh.net\/abstracts\/#website\",\"url\":\"https:\/\/angh.net\/abstracts\/\",\"name\":\"Abstracts des congr\u00e8s de l&#039;ANGH\",\"description\":\"Base de donn\u00e9es des abstracts du congr\u00e8s depuis 2003\",\"publisher\":{\"@id\":\"https:\/\/angh.net\/abstracts\/#organization\"},\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\/\/angh.net\/abstracts\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"fr-FR\"},{\"@type\":\"Organization\",\"@id\":\"https:\/\/angh.net\/abstracts\/#organization\",\"name\":\"ANGH\",\"url\":\"https:\/\/angh.net\/abstracts\/\",\"logo\":{\"@type\":\"ImageObject\",\"inLanguage\":\"fr-FR\",\"@id\":\"https:\/\/angh.net\/abstracts\/#\/schema\/logo\/image\/\",\"url\":\"https:\/\/angh.net\/abstracts\/wp-content\/uploads\/sites\/2\/2018\/10\/logo_angh_2018_-48px.jpg\",\"contentUrl\":\"https:\/\/angh.net\/abstracts\/wp-content\/uploads\/sites\/2\/2018\/10\/logo_angh_2018_-48px.jpg\",\"width\":48,\"height\":18,\"caption\":\"ANGH\"},\"image\":{\"@id\":\"https:\/\/angh.net\/abstracts\/#\/schema\/logo\/image\/\"},\"sameAs\":[\"https:\/\/www.facebook.com\/ANGH-2136322560030484\/\"]},{\"@type\":\"Person\",\"@id\":\"https:\/\/angh.net\/abstracts\/#\/schema\/person\/f532083854369dca4b9f509cfbad90e1\",\"name\":\"abstracts\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"fr-FR\",\"@id\":\"https:\/\/secure.gravatar.com\/avatar\/2bb25d9cedd377e33f0ebc4fb5994a2f9d3e02f897704acdcc173c15b7c75253?s=96&d=mm&r=g\",\"url\":\"https:\/\/secure.gravatar.com\/avatar\/2bb25d9cedd377e33f0ebc4fb5994a2f9d3e02f897704acdcc173c15b7c75253?s=96&d=mm&r=g\",\"contentUrl\":\"https:\/\/secure.gravatar.com\/avatar\/2bb25d9cedd377e33f0ebc4fb5994a2f9d3e02f897704acdcc173c15b7c75253?s=96&d=mm&r=g\",\"caption\":\"abstracts\"},\"url\":\"https:\/\/angh.net\/abstracts\/author\/abstracts\/\"}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Cas clinique : Une complication neurologique inhabituelle au cours d'une maladie de Crohn s\u00e9v\u00e8re - Abstracts des congr\u00e8s de l&#039;ANGH","description":"ANGH R\u00e9sum\u00e9s congr\u00e8s H\u00e9patologie Gastroent\u00e9romogie Hepatology Gastroenterology Etudes cliniques Clinical study","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/angh.net\/abstracts\/cas-clinique-une-complication-neurologique-inhabituelle-au-cours-dune-maladie-de-crohn-severe\/","og_locale":"fr_FR","og_type":"article","og_title":"Cas clinique : Une complication neurologique inhabituelle au cours d'une maladie de Crohn s\u00e9v\u00e8re - Abstracts des congr\u00e8s de l&#039;ANGH","og_description":"ANGH R\u00e9sum\u00e9s congr\u00e8s H\u00e9patologie Gastroent\u00e9romogie Hepatology Gastroenterology Etudes cliniques Clinical study","og_url":"https:\/\/angh.net\/abstracts\/cas-clinique-une-complication-neurologique-inhabituelle-au-cours-dune-maladie-de-crohn-severe\/","og_site_name":"Abstracts des congr\u00e8s de l&#039;ANGH","article_publisher":"https:\/\/www.facebook.com\/ANGH-2136322560030484\/","article_published_time":"2017-10-01T00:00:00+00:00","article_modified_time":"2018-10-20T16:40:25+00:00","author":"abstracts","twitter_card":"summary_large_image","twitter_misc":{"\u00c9crit par":"abstracts","Dur\u00e9e de lecture estim\u00e9e":"2 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"Article","@id":"https:\/\/angh.net\/abstracts\/cas-clinique-une-complication-neurologique-inhabituelle-au-cours-dune-maladie-de-crohn-severe\/#article","isPartOf":{"@id":"https:\/\/angh.net\/abstracts\/cas-clinique-une-complication-neurologique-inhabituelle-au-cours-dune-maladie-de-crohn-severe\/"},"author":{"name":"abstracts","@id":"https:\/\/angh.net\/abstracts\/#\/schema\/person\/f532083854369dca4b9f509cfbad90e1"},"headline":"Cas clinique : Une complication neurologique inhabituelle au cours d&rsquo;une maladie de Crohn s\u00e9v\u00e8re","datePublished":"2017-10-01T00:00:00+00:00","dateModified":"2018-10-20T16:40:25+00:00","mainEntityOfPage":{"@id":"https:\/\/angh.net\/abstracts\/cas-clinique-une-complication-neurologique-inhabituelle-au-cours-dune-maladie-de-crohn-severe\/"},"wordCount":454,"commentCount":0,"publisher":{"@id":"https:\/\/angh.net\/abstracts\/#organization"},"keywords":["2017"],"articleSection":["Gastroenterologie"],"inLanguage":"fr-FR"},{"@type":"WebPage","@id":"https:\/\/angh.net\/abstracts\/cas-clinique-une-complication-neurologique-inhabituelle-au-cours-dune-maladie-de-crohn-severe\/","url":"https:\/\/angh.net\/abstracts\/cas-clinique-une-complication-neurologique-inhabituelle-au-cours-dune-maladie-de-crohn-severe\/","name":"Cas clinique : Une complication neurologique inhabituelle au cours d'une maladie de Crohn s\u00e9v\u00e8re - Abstracts des congr\u00e8s de l&#039;ANGH","isPartOf":{"@id":"https:\/\/angh.net\/abstracts\/#website"},"datePublished":"2017-10-01T00:00:00+00:00","dateModified":"2018-10-20T16:40:25+00:00","description":"ANGH R\u00e9sum\u00e9s congr\u00e8s H\u00e9patologie Gastroent\u00e9romogie Hepatology Gastroenterology Etudes cliniques Clinical study","breadcrumb":{"@id":"https:\/\/angh.net\/abstracts\/cas-clinique-une-complication-neurologique-inhabituelle-au-cours-dune-maladie-de-crohn-severe\/#breadcrumb"},"inLanguage":"fr-FR","potentialAction":[{"@type":"ReadAction","target":["https:\/\/angh.net\/abstracts\/cas-clinique-une-complication-neurologique-inhabituelle-au-cours-dune-maladie-de-crohn-severe\/"]}]},{"@type":"BreadcrumbList","@id":"https:\/\/angh.net\/abstracts\/cas-clinique-une-complication-neurologique-inhabituelle-au-cours-dune-maladie-de-crohn-severe\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Accueil","item":"https:\/\/angh.net\/abstracts\/"},{"@type":"ListItem","position":2,"name":"Cas clinique : Une complication neurologique inhabituelle au cours d&rsquo;une maladie de Crohn s\u00e9v\u00e8re"}]},{"@type":"WebSite","@id":"https:\/\/angh.net\/abstracts\/#website","url":"https:\/\/angh.net\/abstracts\/","name":"Abstracts des congr\u00e8s de l&#039;ANGH","description":"Base de donn\u00e9es des abstracts du congr\u00e8s depuis 2003","publisher":{"@id":"https:\/\/angh.net\/abstracts\/#organization"},"potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/angh.net\/abstracts\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"fr-FR"},{"@type":"Organization","@id":"https:\/\/angh.net\/abstracts\/#organization","name":"ANGH","url":"https:\/\/angh.net\/abstracts\/","logo":{"@type":"ImageObject","inLanguage":"fr-FR","@id":"https:\/\/angh.net\/abstracts\/#\/schema\/logo\/image\/","url":"https:\/\/angh.net\/abstracts\/wp-content\/uploads\/sites\/2\/2018\/10\/logo_angh_2018_-48px.jpg","contentUrl":"https:\/\/angh.net\/abstracts\/wp-content\/uploads\/sites\/2\/2018\/10\/logo_angh_2018_-48px.jpg","width":48,"height":18,"caption":"ANGH"},"image":{"@id":"https:\/\/angh.net\/abstracts\/#\/schema\/logo\/image\/"},"sameAs":["https:\/\/www.facebook.com\/ANGH-2136322560030484\/"]},{"@type":"Person","@id":"https:\/\/angh.net\/abstracts\/#\/schema\/person\/f532083854369dca4b9f509cfbad90e1","name":"abstracts","image":{"@type":"ImageObject","inLanguage":"fr-FR","@id":"https:\/\/secure.gravatar.com\/avatar\/2bb25d9cedd377e33f0ebc4fb5994a2f9d3e02f897704acdcc173c15b7c75253?s=96&d=mm&r=g","url":"https:\/\/secure.gravatar.com\/avatar\/2bb25d9cedd377e33f0ebc4fb5994a2f9d3e02f897704acdcc173c15b7c75253?s=96&d=mm&r=g","contentUrl":"https:\/\/secure.gravatar.com\/avatar\/2bb25d9cedd377e33f0ebc4fb5994a2f9d3e02f897704acdcc173c15b7c75253?s=96&d=mm&r=g","caption":"abstracts"},"url":"https:\/\/angh.net\/abstracts\/author\/abstracts\/"}]}},"_links":{"self":[{"href":"https:\/\/angh.net\/abstracts\/wp-json\/wp\/v2\/posts\/2073","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/angh.net\/abstracts\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/angh.net\/abstracts\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/angh.net\/abstracts\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/angh.net\/abstracts\/wp-json\/wp\/v2\/comments?post=2073"}],"version-history":[{"count":0,"href":"https:\/\/angh.net\/abstracts\/wp-json\/wp\/v2\/posts\/2073\/revisions"}],"wp:attachment":[{"href":"https:\/\/angh.net\/abstracts\/wp-json\/wp\/v2\/media?parent=2073"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/angh.net\/abstracts\/wp-json\/wp\/v2\/categories?post=2073"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/angh.net\/abstracts\/wp-json\/wp\/v2\/tags?post=2073"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}