Dr. Daniel Cameron: Inside Lyme Podcast

COVID-19 or Lyme disease triggers autoimmune dysfunction?

COVID-19 or Lyme disease triggers autoimmune dysfunction

Welcome to another edition of Inside Lyme Podcast with Dr. Daniel Cameron. I will be discussing autonomic dysfunction in a 64-year-old woman where COVID-19 or Lyme disease triggered autoimmune dysfunction.

This case was featured in the journal eNeurologicalSci in 2020. According to the author, a 60-year-old woman was diagnosed with Lyme disease based on a tick bite, Bull’s eye rash, joint pain, and swollen lymph nodes. [1] She was treated with a 3-week course of doxycycline.

“Three months later, she experienced headaches, several pain syndromes, disabling fatigue, brain fog, and mood lability,” wrote Novak.

She was then diagnosed with two autonomic disorders. Her distal burning sensation without weakness were diagnosed as small fiber neuropathy (SNF). Her dizziness, brain fog, and fatigue were diagnosed as orthostatic hypoperfusion syndrome (OCHOS).

She continued to suffer from both autonomic issues, despite treatment with rifampin, cefuroxime, and cefdinir. “The autonomic testing findings (SFN and OCHOS) were attributed to Post-Treatment Lyme Disease Syndrome (PTLDS),” wrote Novak. She improved with symptomatic and physical therapy.

IVIG reduces symptoms in COVID-19 and Lyme patient

Four years later, at age 64, she was diagnosed with COVID-19 pneumonia. She was treated with a 5-day course of hydroxychloroquine and azithromycin. She improved to near baseline within a week of treatment.

“Two weeks later she experienced new symptoms such as severe leg pain with burning sensation at feet and hands, twitching and vibration feeling at her face, blurred vision, headaches, brain fog, forgetfulness, chronic fatigue, orthostatic dizziness and urinary incontinence but no weakness or dyspnea,” wrote Novak.

She was diagnosed clinically with autonomic disease as the testing could not be performed due to COVID-19 related safety restrictions.

She improved with immunotherapy with IVIG. Immunotherapy successfully resolved her leg pain, brain fog, urinary problems, and  blurred vision. Her headaches and chronic fatigue improved by about 50%.

Author concludes: COVID-19 infection triggered autoimmune reaction.

Editor’s note: I would have questioned whether the autonomic dysfunction was related to COVID-19 or Lyme disease. Fortunately, the 64-year-old woman with a history of headaches, hypothyroidism, and autonomic dysfunction from PTLDS was able to recover from COVID-19.

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References:
  1. Novak P. Post COVID-19 syndrome associated with orthostatic cerebral hypoperfusion syndrome, small fiber neuropathy and benefit of immunotherapy: a case report. eNeurologicalSci. 2020;21:100276.
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5 Replies to "COVID-19 or Lyme disease triggers autoimmune dysfunction?"

  • Jean P Lozoraitis
    03/31/2021 (8:15 am)
    Reply

    Hello..need to know something. I have history of Lyme Disease, battling symptons for decades. I am 70. I just got my first covid vaccine two and one half weeks ago. About 5 days ago, I got bitten by another tick. Symptoms came rushing in. Found an informed physician;s assistant who gave me 21 day supply of doxy. Surprisingly, the doxy isn’t significantly reducing symptoms. I want to know if the vaccine can stimulate the immune system so it is working overtime, responding to new infection in body, and possibly attacking healthy cells? I am afraid to get the second dose.Am feeling really sick despite the treatment. This is unusual for me. I usually respond quickly to antibiotics. Every doctor I talk to says there shouldn’t be any problem taking vaccine if you have or had Lyme.

    • Dr. Daniel Cameron
      04/01/2021 (8:23 am)
      Reply

      I would have the same questions.  Lyme disease, COVID-19 and the vaccine affect the immune system. I am happy the doctor recognized and treated your Lyme disease. I tend to favor completion of the vaccine due to the severity of COVID-19 in some individuals. My patients have tolerated the vaccine. I have some readers who have not. You will have to work with your doctor to help you make a decision. 

  • Frances Locastro
    01/30/2021 (12:11 pm)
    Reply

    Hello Dr. Cameron, I’m originally from Syracuse New York but now live in Boise Idaho. I’ve gone to dozens and dozens of doctors and in 2020 was in the hospital four times with every symptom of covid but they diagnosed me with pericarditis.They called in infectious disease doctors at the time finally. But my test did not show Lyme disease according to them. The reason I write you is that I am feeling near death have been suffering with the severe painful burning sweating condition, severe muscle and joints pain which makes me feel paralized. I believe is caused by Lyme disease. I’ve seen dozens of doctors but I believe they’re missing something here. How do I go about contacting you. I am 67 years old, and test showed that I tested positive for lyme disease years ago but many doctors said no it was not active. I can explain details more as how do I get to see you. I can barely move or walk. The neurologist is considering autonomic disease as the small fiber neuropathy tested negative. My phone number is 208-505-7567.

    • Dr. Daniel Cameron
      01/30/2021 (1:12 pm)
      Reply

      I have patients in my practice with similar concerns. I typically look for Babesia if there are sweats and unresolved symptoms after an extensive evaluation.  I often have seen autonomic issues in my patients. Give my office a call at 914-666-4665 if you have any questions.

    • TLK
      01/30/2021 (3:30 pm)
      Reply

      Reply to F Locastro: Bartonella? Best lab for Bartonella test is Galaxy Labs of North Carolina. It takes approximately 3 weeks for results.


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