Sarcoidosis triggered by Lyme disease
Sarcoidosis is an inflammatory disease that affects multiple organs in the body, typically the lungs and lymph glands. The exact cause of sarcoidosis is unknown. But some researchers believe it may be a type of autoimmune disease, involving an abnormal immune response.
According to the American Lung Association, an “infection or exposure to something in the environment can trigger the immune system to overreact,” resulting in sarcoidosis.¹ In a 2018 study, van Dee and colleagues suggest that Borrelia burgdorferi, the Lyme disease bacterium, may be one of those infectious pathogens capable of triggering sarcoidosis. ²
Their study entitled “Systemic Sarcoidosis Associated with Exposure to Borrelia burgdorferi in a 21-Year-Old Man” describes the case of a 21-year-old forestry worker who was admitted to the emergency department with a history of headaches, a droopy left eyelid and swelling and redness of both legs.
The patient also had “a stinging pain behind his sternum, fatigue, weight loss, loss of appetite, thirst and nycturia,” the authors wrote.
Results from lymph node and skin biopsies indicated non-caseating granuloma, leading to a diagnosis of systemic sarcoidosis. The condition had impacted the man’s lungs, kidneys and skin.
[bctt tweet=”Lyme disease triggers sarcoidosis, an inflammatory disorder that usually affects the lungs and lymph glands. ” username=”DrDanielCameron”]Following the sarcoidosis diagnosis, a spinal tap for Lyme disease was performed based on the patient’s exposure to ticks as a forestry worker and his symptoms.
Lyme disease test results were positive. He was treated with a combination of high-dose prednisolone and antibiotics. He also received 2 weeks of intravenous ceftriaxone followed by 4 weeks of oral doxycycline.
“The patient recovered quickly within a few days of starting a high-dose prednisolone regime, and was discharged free of symptoms and in good health,” the authors wrote
Additionally, “Borrelia-like” organisms have been described within biopsy specimens in patients with cutaneous sarcoidosis, according to a 2009 study.³
“Usually single spirochetes, rarely pairs or small clusters of bacteria were observed between collagen bundles or at the periphery of granulomas,” the authors wrote
Conclusion:
Clinicians “should maintain a high index of suspicion for underlying infectious processes like neuroborreliosis in patients with new-onset sarcoidosis before starting immunosuppressive regimens,” van Dee suggests.
UPDATED: June 30, 2021
Related Articles:
Lyme disease manifests as autoimmune disorder
References:
- American Lung Association. https://www.lung.org
- van Dee, L., Stehouwer, M., & van Bemmel, T. (2018). Systemic Sarcoidosis Associated with Exposure to Borrelia burgdorferi in a 21-Year-Old Man. European Journal of Case Reports in Internal Medicine, 5(10).
- Derler AM, Eisendle K, Baltaci M, Obermoser G, Zelger B. High prevalence of ‘Borrelia-like’ organisms in skin biopsies of sarcoidosis patients from Western Austria. J Cutan Pathol. 2009 Dec;36(12):1262-8. doi: 10.1111/j.1600-0560.2009.01271.x. PMID: 19469874.
Pamela Koelbel
03/23/2024 (3:52 am)
Also I had bad nasal sinus polyps and had surgery to remove them. I’m going to have a specialized eye exam.
David B
04/02/2023 (9:55 am)
I am here because I have recently been diagnosed with Australian Borreliosis – a Hybrid of Lymes disease.
I have had it for three months and suffered from a blood clot then Poly Myalgia since the covid vaccine before this, so I thought the Lymes disease was my poly myalgia. It wasn’t
Funnily enough when I went to hospital in an ambulance as late stage Borreliosis was preventing me from walking .. they found a blood clot n my left lung.
Crazy..
Dr. Daniel Cameron
04/08/2023 (8:49 pm)
I have patients with overlapping medical conditions that are difficult to diagnose and treat. I glad they found the clot as part of there workup.
Pamela Koelbel
03/23/2024 (3:40 am)
My two shin lesions show sacroidosis. I got bit by a black legged tick in 2015. I had exposure to molds too. I developed primary hpt on omeprazole so there was an overlap of symptoms. I had 3.5 parathyroidectomy in Tampa. My gland seems to be working good. I could have got bit by other ticks hiking and gardening. I ruptured my appendix and then noticed the leg lesions come up in 2021. I saw a resident for 2 years so they weren’t biopsied until 2024. I had ground glass opacities in my lungs 1/2023. By Springtime the ground glass opacities were gone. I had normal PFT testing. I did have thrush throughout my body too. I discontinued omeprazole 11/2022 when I started noticing some correlation with myopathy in shoulder and thighs. I haven’t thrown any more kidney stones since 2021. My heart did have QT prolongation, PVCs, t wave morphology changed and SVT. I’m waiting to see these next ekg results. I have some hypertrophy. My eyes are dry and have photophobia. Have floaters. My ears ring loud and constantly. And I had bleeding and drainage from my ear canal. (Is that related?) I have peripheral neuropathy and my back is stiff. I had leukopenia but thought that was from omeprazole. I got Covid when my WBCs were low. My kidneys won’t excrete calcium and my providers have done nothing on that.
The improvements are I did not get Covid recently when my husband did. My lungs are clear. No lymphs. My shin lesions went from red to more flesh color. My eye MD said my eyes do look as advanced for cataracts. My liver is back to normal on enzymes and bilirubin. My bowels are improving. I can sleep on my left side now. I worry about my kidneys, eyes, heart and neuro symptoms. If my lungs improved, will the rest of me? I’m getting a tick test from Igenex. I was going to have candida and mold testing too. Anything else? My ANA was 77 out of 85 scale.
Dr. Daniel Cameron
03/23/2024 (9:28 am)
I am happy to hear you are being carefully evaluated. I blogs on sarcoidosis to bring attention to Lyme as a factor. I have had patients with two conditions, one of which is Lyme. I find it difficult to be sure which symptom is Lyme and what is the other disease.
Jamie McPherson
09/15/2022 (9:33 pm)
Hi Dr. Cameron. I was bitten by a tick and contracted HME (ehrlchiosis) but was never told i had lyme. On a recebt blot test.. I had a postive Igm p23ab anitbody but all others were negative. I have all the symptoms of lyme currently . Could i still have chronic lyme?
Dr. Daniel Cameron
09/16/2022 (8:41 am)
The tests are not as reliable as I would like. Furthermore, the treatment for Ehrlichia may have interfered with future tests. I advise my patients to use clinical judgement if they remain ill after looking at other illnesses.
Jamie McPherson
09/16/2022 (9:42 am)
Thank you for the reply! I plan on getting the ELISA test today to see if that indicates a positive result for lyme.
Paul Armstrong
06/10/2022 (10:39 am)
Interesting article and comment from Lauren on 16/5/22 . Im also UK based and have just had a Synovectomy of the right middle finger and palm after 9 months of swelling in the tendon and the Histology report from biopsy says Sarcoidosis . I was bitten multiple times by deer ticks on one particular day some 6 months before the tendon swelling started and as there was no bullseye rash at the time of the bites I didn’t seek medical attention and forgot about the incident.
I only thought about Lyme as a cause of the swelling after I then started to experience other symptoms such as stabbing pains in ankles and toes as well as shoulder , wrist and elbow pain . Rheumatologist dismissed any suggestions of Lyme and a one stage basic NHS blood test proved negative for Lyme.
Just yesterday , 9th June 22 , the surgeon who did the synovectomy on my hand broke the news of the sarcoidosis diagnosis and he’s just submitted the histology report to the Rheumatologist who dismissed Lyme so it’ll be interesting to see what he now says when I show him this article, although I suspect he’ll still dismiss the Lyme link .
Mary
05/28/2022 (6:21 am)
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6301890/