The association of thrombocytopaenia and Lyme disease

Abstract

The association of asymptomatic thrombocytopaenia in six patients with acute Lyme disease is described. Recovery from thrombocytopaenia occurred shortly following antibiotic therapy. Patients residing in endemic areas for Lyme disease who present with flu-like symptoms and laboratory findings of thrombocytopaenia should prompt suspicion of acute Lyme disease. Appropriate clinical studies should be undertaken to confirm the diagnosis.

Thrombocytopenia and Borrelia burgdorferi: An Association Remains Unproven

“…Moreover, to the best of our knowledge, despite increasing awareness in Germany, no cases of HGE have been reported (V. Fingerle, Max von Pettenkofer-Institut, Munich, personal communication). Finally, leukopenia, anemia, and elevated serum aminotransferase, classical manifestations of HGE [3,4], were never observed in our patient. We thus feel confident that coinfection with HGE can be safely excluded.…”

“…However, the authors fail to indicate that in a subsequent letter evidence was provided that the patient was coinfected with the agent of human granulocytic ehrlichiosis (HGE), an infection closely associated with thrombocytopenia [3]. Second, they cite a report of 6 patients with thrombocytopenia and clinical or serological evidence of B. burgdorferi infection [4]. However, this report from Westchester County, New York, was published prior to the recognition of HGE in this area.…”

Hematological Features in Sheep with IgG and IgM Antibodies against Borrelia burgdorferi sensu lato

“…This decrease of the number of PLTs may be attributed to increased platelet consumption or destruction rather than diminished production. In previous studies in human [36,71,72] and mice [73], normal number of megakaryocytes with absence of morphological abnormalities were observed, in bone marrow biopsies. More specific, spirochetes binding to integrins αIIbβ3, glycoproteins of the platelet membrane results in platelet activation and subsequent cell damage and removal from the circulation [36,74,75].…”

“…Positive and negative antibody reactions are shown in Figure 1. Hematological alterations associated with Lyme disease in humans have been firstly described in 1994 in the United states [36] and in Europe in 1988 [37], with the presence of thrombocytopenia and thrombocytopenic purpura, respectively. Similarly, anemia and thrombocytopenia, associated with Borrelia persica species were first reported in cats and dogs in Israel [38].…”

Pancytopenia in a patient with Lyme disease

“…During the initial dissemination phase, B. burgdorferi seeds the bone-marrow [3]. Various reports have recognized thrombocytopenia and bone marrow granulomas as hematologic manifestations of Lyme disease [4][5][6], although pancytopenia has not previously been described. Making a diagnosis of Lyme-related pancytopenia is dependent on ruling out alternative diagnoses, especially A. phagocytophila, and B. microti, both of which are also transmitted by Ixodes dammini, and can cause hematologic manifestations.…”