Lyme disease is caused by the borrelia bacteria and can lead a variety of health complications if left untreated. Between three and 30 days after being bitten by an infected tick, a person may experience symptoms that resemble the flu, such as a fever, muscle and joint aches, headache, chills, and swollen lymph nodes.
A bulls-eye rash also appears around the site of the bite for the majority of people who have contracted the disease; however, 20–30% of people may not get a rash at all. Because of these non-specific symptoms, many people may not know that they’ve contracted Lyme disease and therefore won’t seek out proper treatment.
As the infection continues to plague the body, more symptoms will develop that can be more severe and damaging. These can include severe headaches and neck stiffness, a loss of muscle tone in the face, arthritis with joint pain and swelling, an irregular heartbeat, inflammation of the brain and spinal cord, and nerve pain. These symptoms can happen days or even months after a person first contracts the infection.
Clearly, Lyme disease has the ability to affect many organs in the body. But can Lyme disease cause jaundice as a result of liver problems?
What is jaundice?
Jaundice, also known as hyperbilirubinemia, is a condition that develops when there is too much bilirubin in the bloodstream. Bilirubin is an orange-yellow pigment naturally produced when red blood cells break down in the body. Ordinarily, the liver is tasked with taking bilirubin from the blood to modify it so that it can be eliminated from the body as bile in feces. When there is too much bilirubin in the bloodstream, it can mean two things: the red blood cells are breaking down too quickly, or the liver isn’t functioning properly in terms of breaking down waste and clearing bilirubin from the blood.
The most common symptom of jaundice is a yellowing of the skin, the whites of the eyes, and the mucous membranes. Not all cases of jaundice are considered severe and can even be left untreated for some adults. However, if jaundice is being caused by severe liver damage, it can lead to serious health complications that can eventually affect brain function.
Can Lyme disease affect the liver?
Lyme disease can affect many organs, and the liver is one of them. However, it is uncommon for Lyme disease to cause liver issues. Because different people will have varied immune responses to the borrelia bacteria infiltrating the body, there are many different health outcomes possible if someone has the infection. Research has found that as many as 40% of people with Lyme disease may have abnormal liver enzymes – i.e. a potentially elevated level of enzymes to indicate inflammation or liver cell damage.
One study found that the specific enzymes that were found to be abnormal in tests with people with Lyme disease were gamma-glutamyl transpeptidase and alanine aminotransferase. Gamma-glutamyl transpeptidase is a transport molecule, which means it is tasked with moving other molecules around the body. It helps the liver metabolize toxins and medications. Alanine aminotransferase helps the liver convert proteins into energy for liver cells. When the levels of these enzymes are affected because of the borrelia bacteria, the liver does not function as it should.
Is jaundice a symptom of Lyme disease?
Although it is incredibly rare, jaundice can be a symptom of Lyme disease if the borrelia bacteria affects how the liver functions. One particular review published in 2019 examined the appearance of jaundice in Lyme disease patients and concluded that there were only two case reports of jaundice in the literature surrounding Lyme disease. One was dated back to 1990, while the other dated back to 2001.
A third case report published in 2020 examined a patient with jaundice and other symptoms of Lyme disease. The positive Lyme disease test was only explored following an extensive workup for other diseases that could cause liver issues. Because of this, it is thought that people with jaundice should be tested for Lyme disease. This is especially true if the person has been in an endemic area. The rarity of case reports surrounding jaundice and Lyme disease does not mean that it doesn’t happen more often; it just means that testing for Lyme disease in patients with jaundice may have been overlooked in the past.
Lyme disease can be a severe and debilitating disease if it is left untreated. Since the symptoms of Lyme disease are non-specific in nature and can mimic other conditions, Lyme should be considered as a differential diagnosis in many cases where jaundice is present. This is especially true if jaundice is accompanied by other symptoms of late-stage Lyme disease, such as arthritis and nervous system issues.
Some damages caused by the borrelia bacteria can be irreversible, so taking stock of the possible symptoms and testing accordingly will help to eliminate a person’s chances of being misdiagnosed with another condition when they need to be treated for Lyme disease.
Featured image by Erik Karits on Unsplash