Macha's curse: an Ulster pedigree

Abstract

Two individuals, a father and son with idiopathic intestinal pseudo-obstruction (IIPO), a familial visceral neuropathy, and major depressive illness are presented. In both the bowel symptoms preceded the onset of the depressive illness – the bowel symptoms presenting in mid-adolescence and the depressive illness presenting in middle age. Both patients required numerous laparotomies and both were treated with a series of ECTs. Both developed vitamin B12 deficiency anaemia and other evidence of malabsorption. At post-mortem both patients showed evidence of distension of the small bowel with volvulus. An extensive pedigree of both conditions overlapping in two inter-related families now extending to the fourth generation with 28 children under the age of 30 is described. Pending further investigation and genetic studies we postulate a possible common neurotransmitter pathology and recommend further neurochemical and histopathological studies of the myenteric plexus in IIPO. Furthermore, the genetic locus of familial IIPO might provide a genetic marker for some forms of primary affective disorder.

The Celts and Macha's curse

“…We coined the term 'Macha's curse' because similar symptoms occurred in a modern Irish pedigree in which depressive illness was combined with Idiopathic Intestinal Pseudo-Obstruction (IIPO). 2 Macha found herself coerced into participating in a race because her husband Crunniuc had boasted that his wife could run faster than Conor's chariot. Despite being heavily pregnant and despite her protestations Macha made the heroic effort against the unequal struggle in order to extricate her foolhardy husband from his fate.…”