Detection of Borrelia burgdorferi DNA and complement membrane attack complex deposits in the sural nerve of a patient with chronic polyneuropathy and tertiary Lyme disease.

Abstract	We report a patient who developed a chronic sensory-motor polyneuropathy and a progressive myelopathy 4 years after a tick bite. An increased serum antibody titer to Borrelia burgdorferi suggested a diagnosis of Lyme neuroborreliosis, although a concomitant cervical spondylosis probably contributed to spinal cord damage. Treatment with ceftriaxone resulted in a marked improvement of neuropathic symptoms, providing indirect evidence of spirochetal infection. Search for B. burgdorferi DNA by polymerase chain reaction amplification on sural nerve confirmed the diagnosis, demonstrating that the spirochete localized in the peripheral nervous system. The presence of complement membrane attack complex deposits and macrophage infiltrates around epineurial vessels and within the endoneurium suggests that the neuropathy in our patient was immune-mediated.
Authors	D Maimone, M Villanova, G Stanta, S Bonin, A Malandrini, G C Guazzi, P Annunziata
Journal	Muscle & nerve (Muscle Nerve) Vol. 20 Issue 8 Pg. 969-75 (Aug 1997) ISSN: 0148-639X [Print] United States
PMID	9236787 (Publication Type: Case Reports, Journal Article)
Chemical References	Antibodies, Bacterial DNA, Bacterial Immunoglobulin G G(M1) Ganglioside Complement System Proteins
Topics	Aged Antibodies, Bacterial (blood) Biopsy Borrelia burgdorferi Group (genetics, isolation & purification) Cell Membrane (immunology, microbiology) Complement System Proteins (immunology) DNA, Bacterial (analysis) G(M1) Ganglioside (immunology) Humans Immunoglobulin G (blood) Lyme Disease (complications, immunology, physiopathology) Male Microcirculation (immunology) Microscopy, Electron Nerve Fibers, Myelinated (immunology, microbiology, pathology) Polymerase Chain Reaction Polyneuropathies (immunology, microbiology) Sural Nerve (blood supply, microbiology, ultrastructure)

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