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[Lyme disease with hepatitis and corticosteroids: a case report]
M Muslmani1, M Gilson, A Sudre
1Service de rhumatologie, hôpital Sud Échirolles, CHU de Grenoble, avenue Kimberley, 38130 Échirolles, France. mmuslmani@chu-grenoble.fr
La Revue De Medecine Interne
|February 28, 2012
Summary
This case study highlights a rare instance of Lyme disease (LD) causing significant liver inflammation. It also questions the role of corticosteroids in potentially worsening LD symptoms without antibiotics.
Area of Science:
- Infectious Diseases
- Hepatology
- Rheumatology
Background:
- Liver function test abnormalities are occasionally noted in Lyme disease (LD).
- Hepatitis directly attributed to LD infection is exceptionally rare in medical literature.
Observation:
- A 78-year-old male with a history of polymyalgia rheumatica (PMR) presented with fever, cholestasis, and cytolysis post-tick exposure.
- Symptoms progressed to meningoradiculitis and erythema migrans, confirming Stage 2 Lyme disease.
- Corticosteroids were reinstituted due to suspected PMR relapse, coinciding with disease progression.
Findings:
- The patient exhibited marked liver inflammation, prompting investigation for co-infection.
- The clinical presentation suggests a potential link between corticosteroid use and Lyme disease severity.
Implications:
- This case underscores the importance of considering Lyme disease hepatitis, though rare.
- It raises awareness about the potential risks of corticosteroid use in Lyme disease patients without concurrent antibiotic treatment.
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