been no cases describing a relationship between Lyme disease caused by Borrelia Burgdorferi and ANCA vasculitis .
In this case , we describe a serologicallyand biopsy-proven pauci-immune crescentic glomerulonephritis with subsequent renal failure in a previously healthy patient just days after presenting with Lyme disease symptoms and serum titers positive for Lyme IgG and IgM antibodies . The exact timing of this patient ’ s Lyme infection is not known . However , the temporal relationship between onset of other manifestations and glomerulonephritis suggests a triggering relationship between Lyme infection and the autoimmune process . While some medications are known to trigger ANCA formation , none of the medications that were prescribed to this patient have been reported to have this association . 9 SARS-CoV-2 infection has also been linked to ANCA formation . 10 However , we view this to be an unlikely trigger in this case , given the eight-week separation between his SARS-CoV-2 diagnosis and
ANCA symptom onset as well as his positive vaccination status .
CONCLUSION
Lyme disease triggering ANCA vasculitis may be an underappreciated occurrence frequently attributed to a primary vasculitis or idiopathic cause . Clinicians should be aware of this relationship and should suspect Lyme disease in patients with new onset ANCA vasculitis , especially in endemic areas such as WV .
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