Open Access Research article

Mapping of hormones and cortisol responses in patients after Lyme neuroborreliosis

Ivar Tjernberg12*, Martin Carlsson1, Jan Ernerudh3, Ingvar Eliasson4 and Pia Forsberg2

Author Affiliations

1 Department of Clinical Chemistry, Kalmar County Hospital, SE-391 85 Kalmar, Sweden

2 Division of Infectious Diseases, Department of Clinical and Experimental Medicine, Linköping University, SE-581 83 Linköping, Sweden

3 Division of Clinical Immunology, Unit of Autoimmunity and Immune Regulation (AIR), Department of Clinical and Experimental Medicine, Linköping University, SE-581 83 Linköping, Sweden

4 Department of Laboratory Medicine, NÄL, SE-461 85 Trollhättan, Sweden

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BMC Infectious Diseases 2010, 10:20  doi:10.1186/1471-2334-10-20

Published: 5 February 2010

Abstract

Background

Persistent symptoms after treatment for neuroborreliosis are common for reasons mainly unknown. These symptoms are often unspecific and could be caused by dysfunctions in endocrine systems, an issue that has not been previously addressed systematically. We therefore mapped hormone levels in patients with previous confirmed Lyme neuroborreliosis of different outcomes and compared them with a healthy control group.

Methods

Twenty patients of a retrospective cohort of patients treated for definite Lyme neuroborreliosis were recruited 2.3 to 3.7 years (median 2.7) after diagnosis, together with 23 healthy controls. Lyme neuroborreliosis patients were stratified into two groups according to a symptom/sign score. All participants underwent anthropometric and physiological investigation as well as an extensive biochemical endocrine investigation including a short high-dose adrenocorticotropic hormone stimulation (Synacthen®) test. In addition to hormonal status, we also examined electrolytes, 25-hydroxy-vitamin D and interleukin-6.

Results

Eight patients (40%) had pronounced symptoms 2-3 years after treatment. This group had a higher cortisol response to synacthen as compared with both controls and the Lyme neuroborreliosis patients without remaining symptoms (p < 0.001 for both comparisons). No other significant differences in the various baseline biochemical parameters, anthropometric or physiological data could be detected across groups.

Conclusions

Apart from a positive association between the occurrence of long-lasting complaints after Lyme neuroborreliosis and cortisol response to synacthen, no corticotropic insufficiency or other serious hormonal dysfunction was found to be associated with remaining symptoms after treatment for Lyme neuroborreliosis.