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.

 

References:

  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.


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

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

    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)
      Reply

      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)
    Reply

    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)
      Reply

      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.

  • Deanna Stazinski
    09/19/2017 (2:57 am)
    Reply

    My son is 8. He had terrible kidney pain a few hours ago. When he was almost 3 yrs old he had severe bladder pain that led him to be hospitalized. Doctors thought it was a brain tumor, extreme pain disorder, Fabry disease…after months in a Chicago hospital, 4 weeks at Mayo, they all gave up. It was lyme disease. He has been on a variety of antibiotics for the past 4 years. I started to take him off about a month ago. Now this pain. I don’t know what to do. I am glad you are puplishing studies about this. I am not surprised Lyme and/or coninfections are causing kidney and bladder pain. My son’s urologist’s do not believe it, but I do.

    • Dr. Daniel Cameron
      09/19/2017 (1:58 pm)
      Reply

      It can be difficult to determine each illness is connected. Various specialists have to weigh in on each issue to make sure you do not miss anything.

  • Carol
    09/19/2017 (5:08 am)
    Reply

    I have had Lyme for about 10+ years my urine infection has got worse.
    I am in continent.

    The NHS refuse to treat more than 2 weeks. Nice guidelines talk about chronic rather than re infection.
    The department of health though it might recognise CE and FDA tests.
    NHS doctors are still in denial thinking that the illness cures itself.
    That a resistance occurs.
    They only treat the condition with oral antibiotics not IV.
    The Big Tick Project done by Bristol University vet scientists using vets to take radium samples from dogs across the UK has found that they are wide spread.
    The south east and south coast and Scotland have always been bad.
    But there is a ridge following the M1.
    Where it’s high.
    I believe it’s to do with the increase in technology transmitters following the road. Along with tree’s meant to hide them. The transmitters and wind turbines don’t comply to levels of electromagnetic fields laid down in
    EMC and EMI law. This is an international
    law. But governments have been ignoring it for sometime. In the US there is a no
    complain law brought in in 97.
    In the U.K. They just removed the legislators in 2002 Radiocommunications Agency and BT’s equivalent was closed to save money.
    The Mod knew back in the 50/60s that increased levels of electropollution/radiation would kill benifical insects.
    While leaving Tick, woodlice cockroaches and other similar creatures still alive. The Butterflies and Bees die along with us humans.
    Governments are more interested in money for licence fees. Industry and the military have told them. But the government think industry and the Mod can solve it. So we die of cancer and possible Lyme Disease. While we are told to eat right and take excersize. Oh and sleep when this stuff goes though our brains.
    For this they will send us to a psychatrist
    who will give us a happy pill.
    Financing both the electronics industry and the pharmaceutical industry.
    There’s more money in the electronics industry than the pharmaceutical industry.
    The Lyme vaccine has not been invented for Humans as yet. They keep saying it’s coming soon.
    Animals are still using Type A OSP whether it really works.
    Or is just a contaminate in the food chain. As animals don’t show pain.
    Their herd members would attack them.
    A vet can’t tell if a dog has Lyme.
    The farmer just excepts the fact cattle and sheep have Lyme.
    While medical doctors don’t talk to vets.
    Preferring to deny there is a problem.
    Local councils in the U.K. Have no strategy. The NHS doctors are not telling them. One vet told the local council in Essex in 2016 that 2 dogs died of a Lyme related infection and others were made sick.
    They put a notice up on the field.
    The Chief Vet was called in he just said he could not see anything.

    One of the Vet scientists at Bristol University said pre-stages of Tick are hard to see.
    We have people in charge who don’t have the right information.
    Even if they are told they do nothing.
    Just like the London Fire a few months ago. Officials just ignore the problem when it gets that bad they have no solution.

    I read that in America homes and vegetation are sprayed just as they have in malaria. 3 times a year…

    A Parks manager told me burning fields was a method of controlling Tick also.
    Trees have been planted in the UK so there is a natural corridor for insects and animals to move.
    I would think the same is happening else where. These creatures are not being contained. What preditors there were are being killed.

    I hope this info does something?


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