MULTIPLE MONONEUROPATHY AND CEREBRAL MENI NGO-ANGIITIS - WEGENERS VASCULITIS OR LYME-DISEASE

The pathogenic mechanisms underlying Lyme disease remain uncertain but an increasing number of reports suggest a vascular inflammatory proce ss. On the other hand, the so-called systemic vasculitides, even thoug h they remain of pathological definition, have recently been character ized by the presence, in the serum, of anti-neutrophil cytoplasmic ant ibodies (ANCA). We report on a patient, finally diagnosed as having ne uroborreliosis, who presented initially with multiple mononeuropathy, ANCA, vascular lesions at muscle biopsy and lymphocytic meningitis. De spite antibiotherapy, he presented with two recurrent strokes, from wh ich he completely recovered He also developed oto-sinusitis. The disea se was finally clinically and biologically controlled by immunosuppres sive therapy. The relationship between angiitis and Lyme disease are d iscussed It is hypothesized that Borrelia burgdorferi infection may ca use a systemic vasculitis following its own course and requiring its o wn treatment.