LIVER and LYME DISEASE
Lyme disease is a multisystem disorder caused by the tick-borne spirochete, Borrelia burgdorferi.
Malaise, fever, myalgia, lymphadenopathy and a distinctive rash: erthema chronicum migrains
Lyme disease may also cause hepatitis:
- In 314 patients with early Lyme disease seen at Yale university, abnormal LFT's in 19%, usually transaminases 
- In a study from NY state (with a control group): 40% .
- In a study from Connecticut: 27% .
- Most frequently GGT and ALT, but jaundice has been described , 
Symptoms occur: nausea, anorexia, weight loss and right upper quadrant pain.
Present within days to weeks after the onset of illness, often in association with the characteristic rash of early Lyme disease: erythema chronicum migrans (time of dissemination).
Can be directly seen on liver biopsy .
Granulomatous hepatitis associated with Lyme disease 
Liver function test abnormalities are common in patients with erythema migrans but were mild, most often not associated with symptoms and improved or resolved by 3 weeks after the onset of antibiotics (tetracycline) , .
- Steere AC, Bartenhagen NH, Craft JE, Hutchinson GJ, Newman JH, Rahn DW, Sigal LH, et al. The early clinical manifestations of Lyme disease. Ann Intern Med 1983; 99: 76-82.
- Horowitz HW, Dworkin B, Forseter G, Nadelman RB, Connolly C, Luciano BB, Nowakowski J, et al. Liver function in early Lyme disease. Hepatology 1996; 23: 1412-7.
- Kazakoff MA, Sinusas K and Macchia C. Liver function test abnormalities in early Lyme disease. Arch Fam Med 1993; 2: 409-13.
- Edwards KS, Kanengiser S, Li KI and Glassman M. Lyme disease presenting as hepatitis and jaundice in a child. Pediatr Infect Dis J 1990; 9: 592-3.
- Cunha BA. Systemic infections affecting the liver. Some cause jaundice, some do not. Postgrad Med 1988; 84: 148-58, 161-3, 166-8.
- Goellner MH, Agger WA, Burgess JH and Duray PH. Hepatitis due to recurrent Lyme disease. Ann Intern Med 1988; 108: 707-8.
- Chavanet P, Pillon D, Lancon JP, Waldner-Combernoux A, Maringe E and Portier H. Granulomatous hepatitis associated with Lyme disease. Lancet 1987; 2: 623-4.
December 19, 2001
For more information go to: Homepage J-F. Dufour, http://www.cx.unibe.ch/ikp/lab7/personJFD.html
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