title: [Pseudotumour cerebri in a patient with Lyme disease and hypothyroidism].
abstract: BACKGROUND
  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.
  
  
  METHODS
  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
authors.affiliation: Unidad de Esclerosis Múltiple, Servicios de Nurología, Hospital Universitario Virgen Macarena, Sevilla, España. sinue@arrakis.es
authors.forename: J M
authors.initials: JM
authors.lastname: García-Moreno
authors.forename: M V
authors.initials: MV
authors.lastname: Borobio-Enciso
authors.forename: S
authors.initials: S
authors.lastname: Angulo-Fraile
authors.forename: G
authors.initials: G
authors.lastname: Izquierdo
mesh_terms: D000328:Adult; D025065:Borrelia burgdorferi / Q000276:immunology; D015897:Comorbidity; D005260:Female; D006801:Humans; D007037:Hypothyroidism / Q000150:complications* / Q000209:etiology* / Q000276:immunology; D007074:Immunoglobulin G / Q000134:cerebrospinal fluid; D008193:Lyme Disease / Q000150:complications* / Q000276:immunology; D011559:Pseudotumor Cerebri / Q000209:etiology*; D013967:Thyroiditis, Autoimmune / Q000209:etiology* / Q000276:immunology
chemical_list: D007074:Immunoglobulin G
vernacular_title: Pseudotumor cerebri en un paciente con enfermedad de Lyme e hipotiroidismo.