Lyme neuroborreliosis
or “neurological Lyme disease” was
evidenced in 2 of 23 patients submitted to strict criteria for case
selection of the Centers for Disease Control and
Prevention employing a two-tier test to detect
antibodies to Borrelia
burgdorferi at a single institution.
One patient had symptomatic
polyradiculoneuritis, dysautonomia, and
serological evidence of early infection; and
another had symptomatic small fiber sensory
neuropathy, distal polyneuropathy,
dysautonomia, and serological evidence of late
infection. In the remaining patients symptoms
initially ascribed to Lyme disease were probably
unrelated to B. burgdorferi
infection. Our findings suggest early
susceptibility and protracted involvement of the
nervous system most likely due to the
immunological effects of B.
burgdorferi infection, although the
exact mechanisms remain uncertain.
The clinical, laboratory, and treatment findings of a patient with chronic acquired demyelinating polyneuropathy (CADP) in association with renal transplantation are described. Like the present case, many such patients have been described under the rubric of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP).
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