[Pseudotumour cerebri in a patient with Lyme disease and hypothyroidism]. / Pseudotumor cerebri en un paciente con enfermedad de Lyme e hipotiroidismo.

INTRODUCTION: Lyme disease is a complex infectious disease affecting multiple organic systems. The most frequent complications are of a dermatological, rheumatological, ophthalmological, cardiac and neurological nature. Among the neurological complications, pseudotumour cerebri is considered to be a rare manifestation of the disease. Hypothyroidism, however, is known to be only infrequently associated to pseudotumour cerebri. Paparone recently reported a case in which Lyme disease and primary hypothyroidism were concurrent, and Becker and Trock described the case of three patients with concurrent thyrotoxicosis and Lyme disease. CASE REPORT: We present the case of a 19 year old female with pseudotumour cerebri and hypothyroidism secondary to autoimmune thyroiditis, which improved after treating her for concomitant Lyme. CONCLUSIONS: We suggest there is a common aetiopathogenic connection between the three processes through autoimmune thyroiditis triggered by Borrelia burgdorferi. Thus, in this patient, the pseudotumour cerebri could be due to either a direct mechanism, triggered by B. burgdorferi, or indirectly, through hypothyroidism secondary to thyroiditis induced by B. burgdorferi, or perhaps to both mechanisms. It might be wise to consider infection by B. burgdorferi in patients with pseudotumour cerebri or thyroiditis coming from areas in which Lyme disease is endemic

Pseudotumor cerebri en un paciente con enfermedad de Lyme e hipotiroidismo / Pseudotumour cerebri in a patient with Lyme disease and hypothyroidism

Introducción. La enfermedad de Lyme es una compleja enfermedad infecciosa que afecta a múltiples sistemas orgánicos. Las complicaciones dermatológicas, reumatológicas, oftalmológicas, cardíacas y neurológicas son las más frecuentes. Entre las complicaciones neurológicas, el pseudotumor cerebri se considera una manifestación rara de la enfermedad. Por otra parte, se sabe que el hipotiroidismo es una asociación poco frecuente del pseudotumor cerebri. Recientemente, Paparone describió un caso de concurrencia de enfermedad de Lyme e hipotiroidismo primario, y Becker y Trock describieron tres pacientes con tirotoxicosis y enfermedad de Lyme concurrente. Caso clínico. Presentamos el caso de una mujer de 19 años de edad con pseudotumor cerebri e hipotiroidismo secundario a tiroiditis autoinmune, que mejoró tras tratarla de una enfermedad de Lyme concomitante. Conclusiones. Planteamos una conexión etiopatogénica común a los tres procesos a través de una tiroiditis autoinmune desencadenada por Borrelia burgdorferi. De esta manera, en esta paciente, el pseudotumor cerebri podría deberse tanto a un mecanismo directo, desencadenado por B. burgdorferi, como a uno indirecto, a través del hipotiroidismo secundario a una tiroiditis inducida po rB.burgdorferi, o bien a ambos mecanismos. Quizá es recomendable considerar la infección por B. burgdorferi en pacientes con pseudotumor cerebri o tiroiditis procedentes de áreas endémicas para la enfermedad de Lyme (AU)

Introduction. Lyme disease is a complex infectious disease affecting multiple organic systems. The most frequent complications are of a dermatological, rheumatological, ophthalmological, cardiac and neurological nature. Among the neurological complications, pseudotumour cerebri is considered to be a rare manifestation of the disease. Hypothyroidism, however, is known to be only infrequently associated to pseudotumour cerebri. Paparone recently reported a case in which Lyme disease and primary hypothyroidism were concurrent, and Becker and Trock described the case of three patients with concurrent thyrotoxicosis and Lyme disease. Case report. We present the case of a 19-year-old female with pseudotumour cerebri and hypothyroidism secondary to autoimmune thyroiditis, which improved after treating her for concomitant Lyme. Conclusions. We suggest there is a common aetiopathogenic connection between the three processes through autoimmune thyroiditis triggered by Borrelia burgdorferi. Thus, in this patient, the pseudotumour cerebri could be due to either a direct mechanism, triggered by B. burgdorferi, or indirectly, through hypothyroidism secondary to thyroiditis induced by B. burgdorferi, or perhaps to both mechanisms. It might be wise to consider infection by B. burgdorferi in patients with pseudotumour cerebri or thyroiditis coming from areas in which Lyme disease is endemic (AU)