title: Liver function test abnormalities in early Lyme disease.
abstract: 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.
  
  
  METHODS
  Case series.
  
  
  METHODS
  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.
  
  
  METHODS
  Thirty-seven female and 36 male patients with erythema migrans who had not yet been treated with antimicrobial agents.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  Subclinical hepatitis is a common finding in early Lyme disease.
authors.affiliation: Family Practice Residency Program, Middlesex Hospital, Middletown, Conn.
authors.forename: M A
authors.initials: MA
authors.lastname: Kazakoff
authors.forename: K
authors.initials: K
authors.lastname: Sinusas
authors.forename: C
authors.initials: C
authors.lastname: Macchia
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D015787:Erythema Chronicum Migrans / Q000097:blood / Q000150:complications / Q000175:diagnosis; D005260:Female; D006801:Humans; D008107:Liver Diseases / Q000097:blood / Q000209:etiology* / Q000503:physiopathology; D008111:Liver Function Tests; D008193:Lyme Disease / Q000097:blood / Q000150:complications / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013997:Time Factors