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.


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

  • Rebecca
    05/19/2020 (9:26 am)
    Reply

    My son had a 3 mm kidney stone at age 4. They said it was caused by high oscillates, but every follow up lab over the next 12 months showed no elevated levels. He was also developing behavior challenges (anger outbursts, anxiety-driven behaviors) around that time. He was finally diagnosed with Lyme and several coinfections at around age 7-1/2. Our Lyme doc didn’t seem surprised to hear about the stone, or that occilates were never found in the follow up nephrology lab-work.

    • Dr. Daniel Cameron
      05/19/2020 (11:50 am)
      Reply

      I am happy to hear your child was eventually treated. I can’t help you on the stone question.

  • POLLY TRIMBLE
    03/25/2020 (11:48 am)
    Reply

    My husband and I both have Lyme and stage 2 kidney disease. We are healthy otherwise. Our primary doctor states this is just a coincidence. Do you have information available I can use to help convience him to investigate further?

    • Dr. Daniel Cameron
      03/25/2020 (6:29 pm)
      Reply

      I have not seen kidney disease in my Lyme disease. I am not a nephrologist. It could be a coincidence.

  • Debbie
    01/16/2020 (7:57 am)
    Reply

    I was interested in this article, since being diagnosed with Anaplasma (a tick borne disease) and then after months of more and more symptoms finally diagnosed with Lyme. Since then I have ended up in Urgent care with unexplainable pain, fatigue and high fevers that come and go. Each time with a question to me do you have pain when your urinate or increased frequency. I had neither each time. However, my urine has had trace of blood and indicates infections. My physical symptoms besides the above mentioned have also been extremely painful lower to mid back and my lower ribs feel like they are being squeezed in a vice. They hurt so bad that I can barely breath when I take a deep breath. From what I was told the pain from my kidneys is radiating and causing this discomfort.
    The fatigue is so bad I can fall asleep have a conversation. Yet, my doctors refuse to connect any of this to Chronic Lyme’s. This past year since being diagnosed in June of 2019. I will be on close to 110 days of antibiotics and still having issues! On top of this I have Guillane Barre Syndrome. So when my system is complicated I have flare ups with my neurological system. Thank you for this study it helps me to take better control of my health. Now to get the doctors to listen!!

  • Joan OBrien-Singer
    10/20/2018 (9:12 pm)
    Reply

    Hello Dr.Cameron

    I now have cystic kidney disease. The first cysts were discovered when I received my first round of IV rocephin many many years ago. My urologist wasn’t concerned about them and my radiologist followed them annually. I still have some Lyme symptoms from time to time however my LLMD in Florida retired so I haven’t had treatment for chronic Lyme for a long time. My thought is that if there is a connection of kidney disease and Lyme in dogs, it makes sense to me since we are both mammals that there must be a connection. I wonder why insufficient research in humans has been underway. I have an appointment with a nephrologist the end of November (first available appointment) and I imagine he will pooh pooh this possibility. I miss NewYork dreadfully if you catch my drift. Warm regards , Joan O’Brien -Singer.

    • Dr. Daniel Cameron
      10/21/2018 (12:53 pm)
      Reply

      Joan
      It have also had a interest in the renal failure seen in dogs. I have not see renal disease in my practice but I am not a nephrologist.

    • Joanne B
      11/20/2018 (12:16 pm)
      Reply

      I am 64 year old female who has also been been diagnosed with cystic kidney disease; incidental finding of cysts in my kidneys and liver on an abdominal CT for other symptoms. My kidney function labs are WNL. I have had Lyme disease and Babesiois for 24 years but not treated promptly. Seeing geneticist currently to test for genetic mutation for PKD, however there is no one in my family with it now I am curious about the connection with Lyme.

      • Dr. Daniel Cameron
        11/20/2018 (1:49 pm)
        Reply

        Dogs with tick borne illnesses commonly present with severe renal disease. I have not seen the same problem in humans. I posted a review of the article to encourage professionals to take a second look at the topic.

  • Valerie Sharlow
    09/13/2018 (9:05 pm)
    Reply

    My 54 year old brother was just diagnosed with stage 4 chronic kidney disease in Syracuse, NY. His doctor told him that it was caused by his Lyme disease. He has been healthy his entire life until this past year. He is meeting with a transplant team next week. I hope to donate a kidney to him if at all possible…but i’m worried about his heart.. If the Lyme attacked his kidneys, then it may have done damage to other organs as well.

    • Dr. Daniel Cameron
      09/14/2018 (1:02 am)
      Reply

      Kidney disease is well documented in dogs. I don’t see renal issue with Lyme disease in my practice. There may be other issues that led the doctor to consider Lyme disease. You may want to include a doctor experienced in treating Lyme disease in your evaluation in case it is a factor.

  • Alison Pinkston
    01/30/2018 (6:49 pm)
    Reply

    Interesting! I was diagnosed with Lyme and chronic kidney disease simultaneously in 2013. No cause for my CKD has been identified (no high blood pressure, diabetes, etc – generally healthy). CKD hasn’t improved with Lyme treatment but hasn’t really worsened either – just high creatinine & low gfr. Lyme symptoms improved greatly but didn’t disapper completely with treatment, CKD has been holding fairly steady – not improved. I now live in an area where Lyme is very rare so just get puzzled looks when I mention it to doctors here – would be interesting and perhaps beneficial to get involved in research on this matter.

    • Dr. Daniel Cameron
      02/01/2018 (12:50 am)
      Reply

      I could find very little information on kidney disease in humans. It is a common problem in dog.

    • Giselle Sherman
      12/08/2019 (7:15 pm)
      Reply

      Sadly, last year my kidney issues were labeled as kidney disease as well and I also have Lyme Disease and Babesia. This year was a horrible year for me as I had 4 kidney incidents and they are becoming more and more frequent. My Nephrologist said she thinks my kidney disease is directly linked to my Lyme Disease however she said she wasn’t Lyme literate and needed to research to figure out how to help me….

      • Dr. Daniel Cameron
        12/09/2019 (9:33 am)
        Reply

        Dogs frequently have kidney disease or kidney failure due to tick borne illnesses. I have not seen kidney problems in my practice. Perhaps other have.

  • Flow
    12/17/2017 (11:17 am)
    Reply

    5 years ago I had a Hanta nephritis (with 3,08mg/dl max., the creatinine was a few month later at a normal stage (1,04mg/dl) again) In July this year, I was infected with lyme disease. I had two antibiosis but I still feel bad. I have high blood pressure, creatinine of 1,42mg/dl and proteinuria. But my doctors don’t believe that there is connection between the lyme disease and the renal insufficiency – because there is nothing in to find in the literature. I hope, you can change this. I wish you all the best for your further work. If I can support you (e.g. labor results), feel free to contact me.

    • Dr. Daniel Cameron
      12/27/2017 (10:36 pm)
      Reply

      There is an urgent need for more research.

    • Kerry Wagner- Lane RPh
      09/10/2019 (5:05 am)
      Reply

      Greetings Flow and all you fellow Lyme Disease sufferers!
      My heart is breaking as I read your blogs for th he first time! My name is Kerry and I was born with Lyme Disease in 1955 and have survived an onslaught of autoimmune disorders, like ALS and MS as well as Lyme Carditis and now Lyme Nephritis! I am a Pharmacist since 1991 and had a very successful and lucrative career spaning 5 States! I also raised 4 children but one, my oldest daughter-39yrs died of untreated and undiagnosed Lyme Disease as the blind Western Medicine MDS had misdiagnosed her with ALS!
      This willfull denial of the truth and the intentional coverup of the greatest crime against the Western World by The CDC’S, FDA’S, DRUG COMPANIES and Western Medicine is the greatest travesty of this generation!
      I need others like you who are willing and able to unite together to fight against the lies and suppression of the Truth by rising up to educate the public concerning the real situation! This is the greatest growing epidemic in the Western Hemisphere!

  • 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?

  • 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.

  • 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.

  • 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.


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