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A 39-year-old woman developed transient erythema and arthralgia in spring 1987. In June she had a tick bite followed by local erythema and later migrating skin changes. Furthermore she developed pain in various joints with Raynaud’s phenomenon at the fingers, swelling of the knee joints and shoulder pain. Demonstration of antibodies against B. burgdorferi antigen was shown in one institution (IFL, Western blot) while the same serum in two other institutions remained negative (IHA, ELISA). Antibiotic treatment was only temporarily successful. While the demonstration of antinuclear factors could be attributed to cross-reacting antibodies in borreliosis failing effects of absorption of serum with this antigen led to the assumption SLE as the underlying
disease. Further indications were lymphopenia, increasing titers of anti ds-DNA antibodies and renal involvement as erythrocyturia and proteinuria. Sudden relief of the symptoms after treatment with steroids may be taken as further prove for this assumption. The interference of both diseases and their similarity in symptoms may impede correct diagnosis.