Neurological manifestations and complications of autoimmune gastrointestinal diseases in children

Abstract

The aim was to investigate the association of neurological disorders with celiac disease and infl ammatory bowel disease (Crohn’s disease, ulcerative colitis and indeterminate colitis) in children and adolescents. The research was conducted retrospectively by collecting data from available hospital documentation at Department of Paediatrics, Split University Hospital Centre, during the period from January 1, 2015 to December 31, 2019. The study included 122 patients diagnosed with infl ammatory bowel disease or celiac disease. The following data were analysed: sex and age at the time of autoimmune bowel disease diagnosis, presence and type of neurological symptoms, and age at the onset of disease manifestation. The greatest proportion of patients suff ered from Crohn’s disease (35.2%), followed by ulcerative colitis (30.3%) and celiac disease (27.9%). The proportion of children with neurological symptoms was 32.4% in patients with celiac disease, 16.2% in those with ulcerative colitis and 4.7% in those with Crohn’s disease. The proportion of children with neurological symptoms was higher in patients with celiac disease than in those with infl ammatory bowel disease, and there was a statistically signifi cant association of neurological symptoms with the type of disease (p=0.005). The most common neurological symptom in the study group was headache; other neurological manifestations were epilepsy, cerebrovascular disease, pervasive developmental disorder, psychomotor developmental delay and tics. In conclusion, infl ammatory bowel diseases and celiac disease are chronic diseases that require long-term follow-up by a gastroenterologist; however, although neurological manifestations are uncommon, some patients develop them, so timely recognition is important, and long-term follow-up by neurologists may be necessary in adulthood.