J Neurogastroenterol Motil.  2015 Jul;21(3):440-442. 10.5056/jnm14118.

Intestinal Pseudoobstruction Caused by Chronic Lyme Neuroborreliosis. A Case Report

• Schefte DF
• Nordentoft T

• KMID: 2433484
• DOI: http://doi.org/10.5056/jnm14118

Abstract

Chronic intestinal pseudoobstruction is often classified as idiopathic. The condition is associated with poor quality of life and high morbidity, and treatment options are often unsatisfactory. A case of chronic intestinal pseudoobstruction in a 66-year-old woman, presenting with back and abdominal pain, urinary retention and severe constipation is described. The patient lived in an area in which Lyme disease is endemic and had been bitten by ixodes ticks. Intrathecal synthesis of anti-borrelia IgM and IgG and lymphocytosis in the cerebrospinal fluid was found, consistent with chronic Lyme neuroborreliosis since symptoms had lasted for more than six months. The patient's gastrointestinal function recovered and the pain subsided significantly following treatment with antibiotics. Lyme neuroborreliosis (LNB) often results in palsy, but rarely affects the autonomic nervous system. Three patients have been described with intestinal pseudoobstruction due to acute LNB. However, this is the first described case of intestinal pseudoobstruction due to chronic Lyme neuroborreliosis. LNB must be suspected in patients with intestinal pseudoobstruction, in particular in patients who have been bitten by an ixodes tick and in patients living in an endemic area.

Keyword

Constipation; Intestinal pseudoobstruction; Lyme neuroborreliosis

MeSH Terms

Abdominal Pain
Aged
Anti-Bacterial Agents
Autonomic Nervous System
Cerebrospinal Fluid
Constipation
Female
Humans
Immunoglobulin G
Immunoglobulin M
Intestinal Pseudo-Obstruction*
Ixodes
Lyme Disease
Lyme Neuroborreliosis*
Lymphocytosis
Paralysis
Quality of Life
Ticks
Urinary Retention
Anti-Bacterial Agents
Immunoglobulin G
Immunoglobulin M