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La maladie de Lyme et le lupus

lupus rash common sites

Éruptions cutanées et de la maladie de lupus de Lyme sont généralement distinctes

Il ya un certain nombre de maladies qui partagent des caractéristiques similaires, problèmes qui se présentent pour le diagnostic et le traitement. La maladie de Lyme, lupus, la fibromyalgie, l'arthrite rhumatoïde, syndrome de fatigue chronique, la sclérose en plaques, et même dans des conditions telles que la schizophrénie, et le trouble bipolaire peut être confondu avec l'autre dans le cadre du diagnostic état d'un patient. Alors que l'éruption de papillon fréquente chez les patients atteints de lupus est tout à fait différente de la mouche Éruption cutanée la maladie de Lyme, il ya d'autres symptômes de lupus et de Lyme qui sont semblables.

Lupus, Lyme et le bloc auriculo-ventriculaire

Un symptôme de la maladie de Lyme qui peuvent également se produire dans le rhumatisme articulaire aigu, et en cas de lupus érythémateux néonatal, est bloc auriculo-ventriculaire. La maladie de Lyme et d'autres états inflammatoires, ainsi que les conditions auto-immunes comme le lupus, peut causer bloc auriculo-ventriculaire qui peuvent être de courte durée et de résoudre naturellement ou nécessitent une intervention sur une base plus permanente, comme ayant un pacemaker. Bloc auriculo-ventriculaire peut être vécu comme des palpitations cardiaques chez un patient présentant la maladie de Lyme ou le lupus, et d'établir la cause est important de manière à appliquer un traitement approprié. La plupart des patients présentant un bloc AV en raison de la maladie de Lyme ont pas de complications cardiaques à long terme à condition que un traitement antibiotique est couronnée de succès dans l'éradication de l'infection et l'état se résorbe habituellement en quelques jours, ou semaines. Un stimulateur cardiaque temporaire peut être nécessaire pendant cette période et que le patient est généralement suivie de près pour attraper toute escalade des symptômes au début.



Lupus patients rarely present with atrioventricular block as an initial symptom and where it does occur it is often rapidly followed by serositis, and subsequent kidney problems and joint problems. Arce-Salinas (et al, 2009) reports one such case of systemic lupus erythematosus in a 19yr-old woman who presented with seizures and a loss of consciousness, and who was diagnosed with complete atrioventricular block requiring a pacemaker. Lyme disease patients may have a first-degree atrioventricular block which only becomes apparent following a standard ECG during diagnosis, whereas a third-degree (complete) atrioventricular block is significantly more severe and requires immediate treatment. The cause of atrioventricular block in Lyme disease patients is more likely to be Lyme carditis, or inflammation of the heart than the electrolyte disturbances that can occur in patients with lupus suffering from compromised renal (kidney) function. Treatment that works for one condition is, therefore, not always helpful for the other.

lyme disease lupus atrioventricular heart block

Third-degree atrioventricular block (complete heart block) is a rare initial symptom of lupus and Lyme disease

Other Shared Symptoms of Lupus and Lyme Disease

Other symptoms shared by patients with Lupus and Lyme disease include fatigue, fever, rashes, arthritis, and central nervous system complications. Lupus nephritis and systemic lupus erythematosus (SLE) both result in these symptoms in some patients and may be mistaken for Lyme disease symptoms in a patient already diagnosed with the infection. Assessing each new symptom on its own merit is important for any patient therefore, and any delays in seeking medical attention may lead to an unnecessary escalation in the severity of their condition. Lyme disease itself may lead to kidney complications that can mirror the symptoms of active lupus nephritis, although Lyme disease kidney failure is usually considered a feature of the disease in dogs rather than humans.

Kidney Dysfunction in Lupus and Lyme Disease


Where lupus is adversely affecting the kidneys, a patient may experience complications with electrolyte regulation and hydration. Symptoms of lupus may be similar to those of late stage Lyme disease with patients experiencing headaches, dizziness, visual disturbances, and signs of cardiac decompensation or atrioventricular block. Lupus nephritis is one of the most serious developments in patients with systemic lupus erythematosus and it usually arises within five years of diagnosis. Renal failure itself rarely occurs without the patient having already met the criteria for SLE however and most patients with lupus are carefully monitored for renal function so as to try to slow down the progression of kidney failure as far as possible. This treatment may involve the use of aggressive immunosuppressant drugs which would be contraindicated in those with Lyme disease. This, again, highlights the importance of differentiating Lyme disease, lupus, and other conditions sharing common traits.

Mononeuritis Multiplex

Lupus and Lyme disease may also be part of a group of disorders brought together under the heading of Mononeuritis multiplex. This is a painful peripheral neuropathy which is asymmetric, asynchronous, and involves both sensory and motor nerve function in at least two distinct nerve areas. Random nerves can be affected at multiple sites around the body and what starts as an asymmetric condition may progress to become more widespread and symmetric. Rheumatoid arthritis, Lyme disease, lupus, diabetes, vasculitis, amyloidosis, Sjogren syndrome, AIDS, scleroderma, and a number of other conditions are associated with the complex which is still in its infancy in terms of medical knowledge and understanding. Although they are distinct medical conditions, Lyme disease and lupus share some common traits and may cause initial confusion if they present atypically in a patient.

References

Arce-Salinas CA, Carmona-Escamilla MA, Rodríguez-García F. Complete atrioventricular block as initial manifestation of systemic lupus erythematosus. Clin Exp Rheumatol. 2009 Mar-Apr;27(2):344-6.