Doctors recognize Lyme disease in a patient with kidney disease

Kidney disease induced by Borrelia burgdorferi has been commonly reported in dogs but in the literature there are only a few cases of Lyme disease-associated renal damage in humans. In the February 2017 issue of BMC Nephrology, Florens and colleagues discuss the “unique case of minimal change disease (MCD) associated with chronic Lyme borreliosis that resolved completely after treatment with ceftriaxone and corticosteroids.” [1]


by Daniel J. Cameron, MD MPH

The article, “Chronic Lyme borreliosis associated with minimal change glomerular disease: a case report,” cites four published papers describing kidney damage in Lyme disease patients. The papers consisted of 4 cases of membranoproliferative glomerulonephritis (MPGN), a case of crescentic and IgA-deposit nephropathy, and a case of membranous nephropathy. [1]

In another case, the authors describe a 65-year-old Caucasian woman admitted for an acute edematous syndrome related to a nephrotic syndrome. She had a history of hypertension, dyslipidemia, and elevated blood pressure of 163/89 mmHg. Laboratory data showed hypoalbuminemia (1,2 g/dl), severe proteinuria (7,03 g/24 h) and a recent decrease of renal function (serum creatinine level increase from 0,84 to 1,3 mg/dl). Renal biopsy showed minimal change glomerular disease (MCD). [1]

Lyme disease was diagnosed based on positive serologic tests and a 2-year history of violaceous skin lesions of the right calf. The lesions were diagnosed as Acrodermatitis chronica atrophicans (ACA) by skin biopsy. ACA is a Lyme disease finding in Europe. The patient recalled a history of a tick bite on the same leg 9 years earlier without a rash or arthritis.

“This patient is the first case of minimal change glomerular disease associated with chronic Lyme borreliosis,” according to Florens from Edouard Herriot Hospital, Lyon, France. The patient’s nephrotic syndrome and MCD resolved with a combination of intravenous ceftriaxone and the steroid prednisolone.

The leg lesions and neuropathic pain, which persisted despite 21 days of ceftriaxone and prednisolone, cleared following a second course of 32 days of IV ceftriaxone therapy along with pregabalin.

Based on their investigations, Florens and colleagues recommend further studies of the association between kidney disease and Lyme disease. “The decrease of proteinuria after ceftriaxone therapy observed in our case suggests a link between MCD and Lyme disease,” according to Florens. “T-cells, podocytes and bacterial wall antigens could be involved.”

This case reminds doctors of the need to recognize Lyme disease in patients with kidney disease even if an association has not been established.



  1. Florens N, Lemoine S, Guebre-Egziabher F, Valour F, Kanitakis J, Rabeyrin M, Juillard L: Chronic Lyme borreliosis associated with minimal change glomerular disease: a case report. BMC Nephrol 2017, 18(1):51.

4 Replies to "Doctors recognize Lyme disease in a patient with kidney disease"

  • Sandy Ellis
    05/24/2017 (9:02 pm)

    I have stage three kidney disease and was positive for lyme disease. I did antibiotics and was tested after treatment with two different labs and still tested positive . I also had colon cancer in 2009.

    • Dr. Daniel Cameron
      05/29/2017 (7:27 pm)

      I am sorry to hear you have such serious kidney disease. I am glad they tried treating for Lyme disease.

  • Joe Walton
    08/16/2017 (12:31 am)

    My 16 year old daughter who is extremely active in sports has been tested positive for Lonestar Tick Disease. Over the past couple years since her diagnosis, she has recently been experiencing extreme fatigue, been light headed, hot/sweaty, and urinates frequently. We took her to a Cardiologist where she tested positive in a tilt test. The doctor gave her Fludocortisone to try to put a hormone in her body to make her body retain water better but it has not helped. She also was prescribed metoprolol. She has been taking it for two weeks with no improvement. Since there is not a lot on the disease, I was wondering if you knew of any similar cases or if her symptoms could even have anything to do with it.

    • Dr. Daniel Cameron
      08/16/2017 (7:34 am)

      Autonomic symptoms are common in tick borne illnesses. Children may be diagnosed with POTS syndrome (postural orthostatic tachycardia syndrome only to be diagnosed later with a tick borne illness. See the following Pubmed article.

Got something to say?

Some html is OK