Multiple sclerosis and HLA-B27 negative sacroiliitis in a Crohns disease patient

SUMMARY A relationship between inflammatory bowel disease and MS is supported by a higher than expected coexistence of these diseases among families and individuals. A 32 year-old male with Crohn’s disease of the terminal ileum diagnosed 4 years earlier and HLA-B27 bilateral sacroiliitis diagnosed two years earlier, was admitted to our hospital because of an acute episode of blurred vision. In addition the patient complained of urine incontinence. Before this admission the patient had been elsewhere administered three doses of Remicade and 16mg of methylprednisolone p.os. During admission the diagnosis of multiple sclerosis was made (MRI and IgG Index) and Remicade was discontinued. The patient was started on therapy with interferon-beta for MS, oxybutynin hydrochloride (10mg/day) for urine incontinence, prednizolone (10mg/day), methotrexate (10mg/week) and azathioprine (100mg/day) for Crohn’s disease and is now in excellent clinical status. To the best of our knowledge this is one of the very rare cases of Crohn’s disease with HLA-B27 negative sacroiliitis preceding multiple sclerosis diagnosis. Key words: Crohn’s disease, inflammatory bowel disease, ulcerative colitis, multiple sclerosis, Remicade