Chronic Lyme borreliosis associated with minimal change glomerular disease: a case report.
There are only few cases of renal pathology induced by Lyme borreliosis in the literature, as this damage is rare and uncommon in humans. This patient is the first case of minimal change glomerular disease associated with chronic Lyme borreliosis.



A 65-year-old Caucasian woman was admitted for an acute edematous syndrome related to a nephrotic syndrome. Clinical examination revealed violaceous skin lesions of the right calf and the gluteal region that occurred 2 years ago. Serological tests were positive for Lyme borreliosis and skin biopsy revealed lesions of chronic atrophic acrodermatitis. Renal biopsy showed minimal change glomerular disease. The skin lesions and the nephrotic syndrome resolved with a sequential treatment with first ceftriaxone and then corticosteroids.



We report here the first case of minimal change disease associated with Lyme borreliosis. The pathogenesis of minimal change disease in the setting of Lyme disease is discussed but the association of Lyme and minimal change disease may imply a synergistic effect of phenotypic and bacterial factors. Regression of proteinuria after a sequential treatment with ceftriaxone and corticosteroids seems to strengthen this conceivable association.
Department of Nephrology, Dialysis and Hypertension, Edouard Herriot Hospital, Hospices Civils de Lyon, 5 Place d'Arsonval, 69437, Lyon, Cedex 03, France. nans.florens@gmail.com.|Université Claude Bernard Lyon 1, Villeurbanne, France. nans.florens@gmail.com.|INSERM U1060, CarMeN, Université Claude Bernard Lyon 1, Lyon, France. nans.florens@gmail.com.
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Florens
Department of Nephrology, Dialysis and Hypertension, Edouard Herriot Hospital, Hospices Civils de Lyon, 5 Place d'Arsonval, 69437, Lyon, Cedex 03, France.|Université Claude Bernard Lyon 1, Villeurbanne, France.|INSERM U1060, CarMeN, Université Claude Bernard Lyon 1, Lyon, France.
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Lemoine
Department of Nephrology, Dialysis and Hypertension, Edouard Herriot Hospital, Hospices Civils de Lyon, 5 Place d'Arsonval, 69437, Lyon, Cedex 03, France.|INSERM U1060, CarMeN, Université Claude Bernard Lyon 1, Lyon, France.
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Guebre-Egziabher
Department of Infectious and Tropical Diseases, Hospices Civils de Lyon, Lyon, France.
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Valour
Deparment of Dermatology, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France.|Department of Pathology, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France.
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Kanitakis
Department of Pathology, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France.
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Rabeyrin
Department of Nephrology, Dialysis and Hypertension, Edouard Herriot Hospital, Hospices Civils de Lyon, 5 Place d'Arsonval, 69437, Lyon, Cedex 03, France.|Université Claude Bernard Lyon 1, Villeurbanne, France.|INSERM U1060, CarMeN, Université Claude Bernard Lyon 1, Lyon, France.
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Juillard
D000169:Acrodermatitis / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002443:Ceftriaxone / Q000627:therapeutic use; D002908:Chronic Disease; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007668:Kidney / Q000473:pathology; D008193:Lyme Disease / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D009402:Nephrosis, Lipoid / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology; D009404:Nephrotic Syndrome / Q000175:diagnosis / Q000209:etiology*; D011239:Prednisolone / Q000627:therapeutic use; D012867:Skin / Q000473:pathology
D000900:Anti-Bacterial Agents; D005938:Glucocorticoids; D002443:Ceftriaxone; D011239:Prednisolone
Borreliosis; Chronic atrophic acrodematitis; Lyme; Minimal change disease