Lyme disease triggers autoimmune disease – Lupus

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.