Borrelia and nephropathy: cryoglobulinaemic membranoproliferative glomerulonephritis responsive to doxycyclin in active Lyme disease

The association of membranoproliferative glomerulonephritis (MPGN) with Lyme borreliosis has only been reported for the C1q-negative subtype. A 64-year-old male presenting with rising creatinine, nephrotic syndrome and monoarthritis few months after a tick bite was noted to have mixed cryoglobulinaemia, a positive borrelia western blot and ‘full-house’ pattern MPGN with interstitial granuloma. Findings resolved with prednisolone and doxycyclin therapy. The histology is consistent with MPGN secondary to cryoglobulinaemia, which has most likely been caused by borrelia infection. ‘Full-house’ pattern MPGN may result from Lyme borreliosis through cryoglobulinaemia and may be treated successfully with the appropriate antibiotic therapy.