Lewis and Sumner syndrome following infliximab treatment in Crohn's disease: A report of 2 cases

✍ Scribed by Stephane Nancey; Françoise Bouhour; Gilles Boschetti; Christophe Magnier; Pierre-Marie Gonneau; Jean-Christophe Souquet; Dominique Kaiserlian; Bernard Flourie

• Publisher: John Wiley and Sons
• Year: 2010
• Tongue: English
• Weight: 141 KB
• Volume: 16
• Category: Article
• ISSN: 1078-0998
• DOI: 10.1002/ibd.21202

✦ Synopsis

To the Editor:

Neurological and demyelinating events have been reported rarely in association with the use of tumor necrosis factor a (TNF-a) antagonists, since only 29 cases were reported in patients exposed to infliximab (IFX) worldwide. These demyelinating diseases included multiple sclerosis, optic neuritis, encephalitis, myelitis, Guillain Barre syndrome, neuropathy, seizures, and leukoencephalopathy.

The Lewis and Sumner syndrome (LSS), also called multifocal acquired demyelinating sensory and motor neuropathy (MADSAM), is a rare, dysimmune multifocal peripheral nerve disorder. First described in 1982 by Lewis et al, 1 it encompasses asymmetric multifocal motor and sensory involvement of the nerve roots and trunks of the upper and lower limbs. LSS is characterized by a predominantly distal, asymmetric weakness mostly affecting the upper and/ or lower limbs with sensory impairment, and by the presence of multifocal persistent conduction blocks. Here we describe the clinical, biological, and electrophysiological features, the course, and also the response to treatment in 2 cases of LSS occurring in Crohn's disease (CD) patients undergoing a successful treatment with IFX.