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In their article “Lyme Borreliosis as a Trigger for Autoimmune Disease,” Yehudina and colleagues present a unique case in which an infection with Borrelia burgdorferi (the bacteria which causes Lyme disease) triggered the autoimmune condition, systemic lupus erythematosus (SLE), also referred to as lupus.¹
As the authors point out, “long-term exposure of the host’s immune system to [Borrelia] spirochetes can contribute to the development of [a new onset] chronic autoimmune disease.”
This case report describes a 35-year-old woman who developed pain in the joints of her hand, episodes of low-grade fever, general weakness and fatigue and skin rashes on her hands and trunk. The woman reported having an insect bite prior to the onset of her symptoms.
“The patient consulted a dermatologist, who prescribed topical treatment (ointment containing steroids) for dermatitis for one month but with no response,” the authors state.
She then consulted with a rheumatologist, who ordered Lyme disease testing, which was positive by Western blot.
The woman was diagnosed with Lyme disease and prescribed a 28-day course of antibiotic treatment with doxycycline.
“Following therapy, her general condition improved with resolution of joint pain, weakness, normalization of body temperature, and decrease in rashes,” the authors state.
“There is strong evidence of the presence of an immune-mediated process in patients with antibiotic resistant [Lyme disease].”
However, 2 months after completing treatment, the woman exhibited new symptoms. She developed low-grade fevers, a butterfly-like bilateral erythema on the cheek, hair loss, pain, morning stiffness in her hands and wrist joints, weight loss and pronounced chilliness of the fingers.
“Taking into account the change in the clinical manifestations, further investigations were conducted to exclude systemic connective tissue diseases and lymphoma,” the authors state.
A skin biopsy was performed and revealed that the woman, in fact, had lupus, an autoimmune disease.
After treatment for the autoimmune disease, her symptoms improved significantly.
The authors conclude, “Long-term exposure of the host’s immune system to spirochetes can cause chronic autoimmune disease.”
“One possible explanation for antibiotic-resistant [Lyme disease] or subsequent autoimmune reactions and diseases is the generation of autoimmunity directly or indirectly mediated by the pathogen and based on molecular mimicry,” the authors point out.
Related Articles:
Can Lyme disease trigger an autoimmune disease?
Lyme disease mimics autoimmune disorder
Lyme disease manifests as autoimmune disorder, Sjogrens Syndrome
References:
- Yehudina Y, Trypilka S. Lyme Borreliosis as a Trigger for Autoimmune Disease. Cureus. 2021 Oct 10;13(10):e18648. doi: 10.7759/cureus.18648. PMID: 34786243; PMCID: PMC8578812.
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Sjogrens, atypical—seronegative with neurological involvement/dysautonomia. Have a history of Lyme, Bartonella, Mycoplasma.
Hi I would find it super helpful to find out the actual “autoimmune Treatment” that was received. Thank you
At the time that I was diagnosed with a +ANA for Lupus with a presentation of pleurisy, the follow-up was using Meloxicam and Hydroxychloroquine between 2009-2015. As symptoms seemed to be well managed, the Meloxicam (15) was halved, then ultimately d/c, as was the Hydroxychloroquine.
Interesting information regarding Lyme/Lupus connection. If it is, in fact, a mimicry of lupus as opposed to diagnosed Lupus, I would love to understand the underlying biochemistry. (I have a history of Lyme and aggressive treatment with months of IV therapy 22 years ago and eight years later experienced what I thought was connected to Lyme but proved to be a positive ANA for Lupus, with pleurisy as the major symptom. I continued under a Rheumatologist care 2009-2015, using Meloxicam 7.5 and Hydroxychloroquine. However, after seeing a Rheumatologist in 2017, she did not concur with the Lupus diagnosis, in spite of a +ANA, as I do not present as having Lupus. I dc the drugs. I haven’t been under treatment since 2017. While the infection left some arthritic conditions in its wake, it is not possible for me to differentiate as to whether the arthritis is post Lyme or the aging process of a decade’s long athlete.
I have patients who have been dismissed as having post Lyme for years without being evaluated for a persistent tick borne infection who have benefits from retreatment.
Join the club. We seem to all suffer the same dilemma. What is it? What’s causing it? I’ve even read many stories about how people who had a periodontal treatment ended up with Lyme disease and other autoimmune disease a few weeks or months later. Testing alone is not reliable in my opinion but maybe better tests have evolved in recent years. I tested positive for Sjogren’s and my family has a history of it on my mother’s side. But I never had any symptoms so I didn’t pay it any concern. 8 years later, it suddenly hit me with full force and this year, Lupus. All through my Lyme treatment, I never had any arthritis or swollen joints. I only suffered neurological symptoms including trigeminal and glossopharyngeal neuralgia and bone pain.
Aging probably bears some blame given how our hormones change and I’ve read that as estrogen levels drop, our immune system changes.
I have patients with Lyme disease who had thought they were suffering from Sjogren’s
The first time I posted on here was in regard to an article you posted about Sjogren’s and Lyme. I believe that Lyme or other tickborn pathogens trigger these autoimmune diseases. I also believe that Herpes viruses also do the same by “confusing” our immune system after prolonged infection.
I wish your office was closer. I thought you were in TX but you’re in NY. That’s too far for me to travel. Even Northern VA Internal Medicine ( Dr. Shor) is a bit far for me to travel on a regular basis when I feel this bad.
I am sorry to hear
Dr. Cameron, I’ve written on this site before but I won’t repeat all the details. After Lyme in 2016, I developed Sjogren’s in 2024 and now Lupus in ’25. I feel absolutely horrible all over and in immense pain in my knees and elbows. This is the most frustrating experience and I am determined to help myself without visiting a doctor. I know that may sound ignorant and irresponsible, but medical care in the US is so exhausting, impersonal and ineffective. I know I would feel even worse from all the stress and frustration.
Just wanted to share my most recent symptoms in regard to the article.
Female, 64 yrs. , VA
I am sorry you are still sick. It sounds like avoiding doctors is not working all that well either
Yes, yes. I hear you. Lesser of evils I suppose. There is a wonderful doctor here who has a Functional medicine practice and I’m considering a visit with her. I’ve heard wonderful things about her from other patients who have autoimmune disorders.
I feel better when looking at your dogs’ thumbnail picture. Perhaps I’ll rescue a dog. Dog’s are always the best medicine in my opinion 😀