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Updated: Aug 23, 2026
Detecting the Lyme Disease Spirochete, Borrelia Burgdorferi, in Ticks Using Nested PCR
Published on: February 4, 2018
Liver function test abnormalities in early Lyme disease
M A Kazakoff1, K Sinusas, C Macchia
1Family Practice Residency Program, Middlesex Hospital, Middletown, Conn.
Objective:
Lyme disease is a widespread, tick-borne, spirochetal infection with multiple organ system involvement Hepatic dysfunction has not been emphasized in the literature. We report clinical findings and laboratory abnormalities in 73 patients with the pathognomonic erythema migrans rash early in the course of the illness.
Design:
Case series.
Setting:
Offices of family physicians in private practice and the model offices of a family practice residency program in the lower Connecticut River valley, an area to which Lyme disease is endemic.
Patients:
Thirty-seven female and 36 male patients with erythema migrans who had not yet been treated with antimicrobial agents.
Main Outcome Measure:
Liver function tests.
Results:
Twenty patients (27%) had liver function abnormalities. Elevation of gamma-glutamyltransferase was the most common finding. Only seven patients (9%) had a positive titer in response to the enzyme-linked immunosorbent assay for Lyme disease. Other laboratory and clinical findings are described.
Conclusion:
Subclinical hepatitis is a common finding in early Lyme disease.
Insights
Early Lyme disease (Borrelia burgdorferi) often involves subclinical hepatitis, with nearly 30% of patients showing liver function abnormalities. This highlights a commonly overlooked aspect of early infection.
Area of Science:
- Infectious Diseases
- Hepatology
- Epidemiology
Background:
- Lyme disease, a tick-borne illness caused by Borrelia burgdorferi, can affect multiple organ systems.
- Hepatic involvement in early Lyme disease is often underreported in medical literature.
Purpose of the Study:
- To investigate the prevalence and characteristics of hepatic dysfunction in patients presenting with early Lyme disease.
- To document clinical and laboratory findings associated with liver abnormalities in this patient cohort.
Main Methods:
- A case series design was employed, analyzing data from 73 patients diagnosed with erythema migrans.
- Patients were recruited from family physician offices in an endemic area for Lyme disease.
- Liver function tests were conducted as the primary outcome measure.
Main Results:
- Twenty patients (27%) exhibited abnormal liver function tests, with elevated gamma-glutamyltransferase being the most frequent finding.
- A low percentage of patients (9%) had positive Lyme disease titers via ELISA, indicating early-stage infection.
- Detailed clinical and laboratory data for all patients were recorded and analyzed.
Conclusions:
- Subclinical hepatitis is a frequent, yet often unrecognized, manifestation of early Lyme disease.
- These findings suggest that liver function should be considered in the comprehensive evaluation of early Lyme disease presentations.
