Mononeuritis multiplex secondary to Lyme neuroborreliosis
| Autor: | Louis W. Merton, Chinar Osman, Liam S. Carroll, Christina Petridou, Haider Katifi, Mark Walker |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
0301 basic medicine
Pathology medicine.medical_specialty 030231 tropical medicine Immunoblotting Radial neuropathy Enzyme-Linked Immunosorbent Assay Biology Microbiology Ulnar neuropathy Mononeuropathy Diagnosis Differential 03 medical and health sciences 0302 clinical medicine Radiculitis medicine Humans Lyme Neuroborreliosis medicine.diagnostic_test Mononeuritis Multiplex Mononeuropathies Middle Aged medicine.disease Anti-Bacterial Agents 030104 developmental biology Infectious Diseases Treatment Outcome England Insect Science Doxycycline Nerve conduction study Parasitology Female Neuroborreliosis |
| Zdroj: | Ticks and tick-borne diseases. 11(6) |
| ISSN: | 1877-9603 |
| Popis: | Lyme neuroborreliosis (LNB) typically presents as a painful radiculitis or a cranial mononeuropathy with lymphocytic meningitis (Bannwarth’s syndrome). Isolated peripheral mononeuropathy or multiple mononeuropathy is less frequently recognised. A 58-year-old female with a background of IgA nephropathy and chronic kidney disease presented with a painful left ulnar neuropathy followed within 3 months by superficial radial neuropathy. Initial serum and cerebrospinal fluid (CSF) analysis were unremarkable; nerve conduction study was in keeping with a mononeuritis multiplex. A superficial radial nerve biopsy demonstrated inflammation with axonal injury consistent with a pathologically possible vasculitis. Borrelia antibodies were identified using enzyme-linked immunosorbent assay and immunoblot in serum consistent with active recent Lyme borreliosis. A 6-week course of doxycycline was initiated with gradual resolution of pain and improved power. A repeat nerve conduction study demonstrated improvement in sensory and motor responses. This case report identifies a peripheral nerve syndrome of a mononeuritis multiplex secondary to LNB in the absence of CSF pleocytosis with excellent outcome following antibiotic treatment. Peripheral nervous system manifestations of Lyme borreliosis can mimic a vasculitic neuropathy and therefore should be considered in individuals presenting with a painful mononeuritis multiplex. |
| Databáze: | OpenAIRE |
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