Can Lyme Disease Trigger Autoimmune Disease Like Lupus?
Can infection trigger autoimmunity?
In rare cases, Lyme disease may contribute to immune dysregulation.
Lupus-like symptoms can sometimes emerge after infection.
Lyme disease may trigger autoimmune disease in some patients, including conditions such as lupus. In rare cases, infection with Borrelia burgdorferi may contribute to immune dysregulation and the development of new autoimmune symptoms.
Researchers have explored whether prolonged immune activation from Lyme disease could contribute to autoimmune responses in susceptible individuals.
Can Lyme Disease Trigger Autoimmune Disease?
In the article
Lyme Borreliosis as a Trigger for Autoimmune Disease
,
Yehudina and colleagues describe a case in which infection with Borrelia burgdorferi appeared to trigger systemic lupus erythematosus (SLE), commonly referred to as lupus.
As the authors explain, “long-term exposure of the host’s immune system to spirochetes can contribute to the development of chronic autoimmune disease.”
The case involved a 35-year-old woman who developed joint pain in her hands, low-grade fevers, fatigue, weakness, and skin rashes on her hands and trunk following an insect bite.
Initially, she was treated by a dermatologist with topical steroids for presumed dermatitis, but her symptoms did not improve.
She was later evaluated by a rheumatologist, who ordered Lyme disease testing. Her Western blot testing was positive for Lyme disease.
The patient was treated with a 28-day course of doxycycline.
“Following therapy, her general condition improved with resolution of joint pain, weakness, normalization of body temperature, and decrease in rashes,” the authors reported.
Autoimmune Symptoms Following Lyme Disease Treatment
Two months after completing treatment, the patient developed new symptoms including:
- Low-grade fevers
- Butterfly-shaped facial rash
- Hair loss
- Morning stiffness and joint pain
- Weight loss
- Pronounced cold sensitivity in the fingers
Because of the evolving clinical picture, additional evaluation was performed to investigate systemic autoimmune disease.
A skin biopsy ultimately confirmed lupus.
After treatment for the autoimmune condition, her symptoms improved significantly.
Possible Link Between Lyme Disease and Autoimmunity
The authors concluded that prolonged exposure of the immune system to spirochetes may contribute to autoimmune disease development in select patients.
One proposed explanation is molecular mimicry, a process in which the immune system mistakenly targets the body’s own tissues after responding to infection.
Immune-mediated mechanisms may contribute to persistent or evolving symptoms in some Lyme disease patients.
Why Lyme Disease and Autoimmune Disorders Can Overlap
Lyme disease and autoimmune conditions such as lupus can share overlapping symptoms including:
- Fatigue
- Joint pain
- Rashes
- Neurologic symptoms
- Inflammatory findings
This overlap can complicate diagnosis, particularly when symptoms evolve over time.
To explore how Lyme disease may mimic or overlap with autoimmune disorders, see
Can Lyme disease trigger an autoimmune disease?.
Clinical Perspective
Although autoimmune complications following Lyme disease appear to be uncommon, this case highlights the complex relationship between infection and immune system activation.
In clinical practice, evolving symptoms after Lyme disease treatment may sometimes require reassessment for autoimmune or inflammatory conditions.
Further research is needed to better understand how infection, immune activation, and genetic susceptibility may interact in select patients.
Clinical Takeaway
Lyme disease may occasionally contribute to autoimmune disease development in susceptible individuals.
Although uncommon, persistent immune activation following infection may play a role in triggering autoimmune symptoms such as lupus in select patients.
Careful clinical reassessment is important when symptoms evolve or new inflammatory findings emerge after Lyme disease treatment.
Related Articles:
Can Lyme disease trigger an autoimmune disease?
Lyme disease mimics autoimmune disorder
Lyme disease manifests as autoimmune disorder, Sjogren’s syndrome
References:
- Yehudina Y, Trypilka S. Lyme Borreliosis as a Trigger for Autoimmune Disease. Cureus. 2021;13(10):e18648.
Dr. Daniel Cameron, MD, MPH
Lyme disease clinician with over 30 years of experience and past president of ILADS.
Symptoms • Testing • Coinfections • Recovery • Pediatric • Prevention
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 😀
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