Can Lyme Disease Mimic Rheumatoid Arthritis
Medications and Treatments18 Jun 2018 Michael M. Hall
Some people with a rheumatoid arthritis diagnosis misdiagnosed.. Untreated Lyme disease can sometimes affect the nervous system . -arthritis-pictures/health-conditions-that-mimicrheumatoidarthritis.aspx#03.Lyme disease results from the spread of Borrelia burgdorferi bacteria living inside infected ticks. These small ticks can attach to human skin and go unnoticed, .Joint pain can have many causes.. Many conditions mimic the hallmark joint pain of rheumatoid arthritis.. See Lyme Disease and Rheumatoid Arthritis vs.Chikungunya virus is often accompanied by joint pain that can persist for months or years and has a serum cytokine profile similar to that of patients with .Lyme disease is a master of disguise and can mimic other conditions, including rheumatoid arthritis. More.I have read that doxy is used to cure rheumatoid arthritis because it is also. Lyme can mimic RA .Lyme disease is an infection caused by bacterium carried by deer ticks. If caught early, it is easily treated with antibiotics. If left untreated, the infection can .Lyme Disease Health Conditions That Mimic Rheumatoid Arthritis-. . Babesia is a coinfection of Lyme disease, which can cause sweats, fatigue and many .Saw a friend at church yesterday who has Rheumatoid Arthritis and is on. That you must first treat the Lyme disease or the arthritis will never get better.. Lyme is often overlooked as a diagnosis because it’s symptoms mimic many other .
How To Prevent Tick
High-risk regions for infection include the Atlantic coast from Maine to Virginia, as well as Minnesota, Wisconsin, and Michigan. Lyme disease was once rare in Canada, but has been steadily ratcheting its range northward as a result of climate change.
If you live in an area where Lyme disease is common, some simple steps can minimize the risk of tick bites:
When To Consider Testing For Lyme
You might be wondering if your joint pain could be related to Lyme disease, especially if youve had a blacklegged tick bite in the past.
The CDC estimates that a staggering 90% of cases of Lyme disease may go undiagnosed in the US each year. So while approximately 30,000 reported cases of Lyme reported annually, as noted, the actual number of cases may be closer to 300,000.
Lyme disease is often called the great imitator, because it mirrors many other diseases. These include, but are not limited to, osteoarthritis, rheumatoid arthritis, and multiple sclerosis. Unfortunately, unless you live in an area considered Lyme endemic, such as the northeastern United States, most conventional doctors may not think to test you for Lyme.
If your symptoms include waxing and waning flu-like symptoms, brain fog, fatigue, or joint pain, and if you think you may have had a tick bite in the past, consider asking your doctor for a test for Lyme disease. Remember that some people with Lyme experience have all of the above symptoms and more, while some experience just one. Also be aware that the ELISA test commonly given by conventional doctors is not always accurate, as it tests for antibodies that may or may not be present at the time of testing. My initial ELISA test came back negative it had been a year since my initial tick bite but my symptoms were in full force.
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Is Your Arthritis Chronic Lyme In Disguise
If you develop joint pain and stiffness as you get older, its easy to assume you have osteoarthritis, a common condition among middle-aged and older adults thats caused by regular old wear and tear.
But before you write off a sudden case of stiff, achy joints as a sign youre not the spring chicken you once were, ask yourself a question Whats my tick exposure like?
Ticks are sneaky little freeloaders. They hide out in grasses and on trees just waiting for the chance to hitch a ride and a meal. And if you spend a lot of time outside, youve probably found more than a few ticks on you over the years.
Hopefully, you found them before they had a chance to sink their fangs into you. But lets face it theyre easy to miss. Sometimes you find one a week later, fat and happy after feasting on your blood. Sometimes you never find them. They hide in your armpit or behind your ear. They fill up on your blood, fall off and go their merry way, while youre none the wiser.
The problem is, these ticks could be carrying Lyme disease bacteria. Now, I know everyone thinks that if youre exposed to Lyme disease bacteria, youll develop symptoms that make it very easy to catch right away, like a bulls eye rash or flu-like symptoms.
Arthritis.
It pops up in around 60 percent of people with untreated Lyme. The question is how do you know if your arthritis is caused by Lyme or not?
Lucky for us, researchers may have just discovered a way
Lyme And Lyme Arthritis
Treatment for Lyme is a course of antibiotics for at least one month, if the tick bite or a Lyme rash is noticed. Lyme arthritis is not likely to occur after antibiotics are given. Doxycycline is usually the initial antibiotic prescribed.
Lyme arthritis is sometimes the first symptom of Lyme. A course of antibiotics will often clear up the arthritis symptoms.
Antibiotics may be given orally or intravenously, depending on the severity of Lyme symptoms.
When Lyme arthritis occurs in the post-infection stage of Lyme, anti-inflammatory drugs such as methotrexate may be used.
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Find Out For Sure If Your Arthritis Is Caused By Chronic Lyme
Unfortunately, you cant go to your doctors office today and get your joints tested for peptidoglycan. So, how do you know if your arthritis symptoms are really a case of chronic Lyme in disguise?
Well, there are certain things to watch out for
Obviously, a history of tick exposure is a huge red flag. But besides that, Lyme arthritis tends to follow a different course than osteoarthritis or other forms of the disease.
People with Lyme arthritis will have sudden attacks of joint swelling in one or more joints. The swelling will last for several weeks or months and then subside, only to return later. These attacks usually start in the knee joint, but they can affect other large joints too. So, if your arthritis starts with waxing and waning attacks, theres a chance its Lyme arthritis rather than osteoarthritis.
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Now, waxing and waning attacks do happen with a different type of arthritis the autoimmune disease rheumatoid arthritis . But there are differences in how RA typically shows up. RA usually starts in the hands, feet, and wrists and affects both sides of the body. Lyme arthritis affects big joints like the knee and only shows up on one side.
Still, if you have strong suspicions about your arthritis, its worth a trip to the doc for some initial testing. Because if your arthritis is caused by a bacterial infection rather than wear and tear it opens a whole new world of treatment options that you may have missed otherwise.
Clinical Characteristics Of Patients
During the 13-year period in which we have been at MGH, 30 patients were referred to us for evaluation of presumed LA in whom we diagnosed a systemic autoimmune joint disorder. Of the 30 patients, 15 had new-onset RA, 13 had new-onset PsA, and 2 had new-onset peripheral SpA. The median duration from the onset of Lyme disease to the start of joint symptoms was 4 months , which is similar to the time frame in which LA may occur after EM .
Duration from Lyme disease to onset of rheumatoid arthritis , psoriatic arthritis or peripheral spondyloarthropathy . For comparison, the duration from erythema migrans, the initial skin lesion of the infection, to onset of Lyme arthritis is shown for historical patients seen in the late 1970s who were not treated with antibiotic therapy . Thus, the duration from erythema migrans to the development of arthritis was known.
The number of patients referred for presumptive Lyme arthritis over a 13-year period, according to the year of referral. The patients were stratified into 3 groups according to our diagnoses of post-Lyme systemic autoimmune joint diseases, antibiotic-refractory Lyme arthritis, or antibiotic-responsive Lyme arthritis.
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Expert Care For Joint Pain From Lyme Disease
At, Aurora Health Care, our team of more than 80 orthopedic specialists has years of experience and training caring for people with joint pain and other problems, like arthritis. This has led to fast and accurate diagnoses for the people we treat so they can return to their busy lifestyles.
Highlights of our program also include:
Lyme Diseaseassociated Autoantibody Responses
Of the 30 patients with systemic autoimmune joint disorders, 27 had sufficient sera available to test for 3 Lyme diseaseâassociated autoantibodies . Of these 27 patients, 6 had positive results for 1 or more of the Lyme diseaseâassociated autoantibodies, and 4 were positive for 2 autoantibodies . Of the 6 patients, 2 had RA, 3 had PsA, and 1 had SpA. In comparison, 19 of the 43 patients with LA had 1 or more of the Lyme diseaseâassociated autoantibodies . Moreover, the levels of ECGF antibodies, the most specific of the Lyme diseaseâassociated autoantibodies , were significantly increased in both the responsive and refractory LA groups compared with the systemic autoimmune disease group . The levels of MMP-10 and Apo-B 100 autoantibodies were significantly greater in the refractory versus the responsive LA group , and MMP-10 levels tended to be greater than those in the systemic autoimmune joint disorder group . In contrast, autoantibody positivity in the LA group and in the postâLyme disease systemic autoimmune disease group were significantly greater than in healthy controls, or in RA or PsA/SpA patients who lacked a history of Lyme disease . Of the 3 LA patients who experienced arthritis that spread to previously uninvolved joints in the postinfectious period, 2 had positive results on tests for MMP-10 autoantibodies, and 1 had reactivity with all 3 autoantibodies.
Figure 4
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How Is It Treated
An initial episode of Lyme arthritis should be treated with a 4-week course of oral antibiotics. Patients with persistent joint inflammation and pain after the first course of antibiotics may require a second course . In some cases, joint swelling and pain can persist or recur after two courses of antibiotics. The cause of persistent arthritis is unknown but is thought to be driven by immunologic factors. Additional antibiotics have not been shown to improve these symptoms, and patient referral to a rheumatologist should be considered.
Lyme Arthritis: Highly Treatable Slow To Resolve
EXPERT ANALYSIS FROM THE ANNUAL PEDIATRIC INFECTIOUS DISEASES CONFERENCE SPONSORED BY CHILDREN’S HOSPITAL COLORADO
VAIL, COLO. Arthritis is far and away the most common manifestation of late Lyme disease, affecting up to 30% of children whose early-stage disease went untreated.
Lyme arthritis presents with a distinctive clinical picture. Nevertheless, this common condition is often initially mismanaged as a joint sprain or other orthopedic injury, with the correct diagnosis coming only following referral after a month or more with no improvement, according to Dr. Roberta L. DeBiasi, acting chief of the division of pediatric infectious diseases at Childrens National Medical Center, Washington.
Dr. Roberta L. DeBiasi
“We see tons of kids with Lyme arthritis. We get two or three cases every week in our clinic,” she said at the conference.
Lyme arthritis occurs months to years after an untreated exposure to Borrelia burgdorferi. Affected patients typically present with a history of recurrent, weeks- or months-long attacks of joint swelling in one or a few joints. The knee is by far the most common site, but other large joints can be involved, as can the temporomandibular joint. An involved knee may swell up to literally the size of a basketball, yet the child has no fever, erythema, or systemic complaints, and surprisingly little pain given the effusion size.
Dr. DeBiasi reported having no financial conflicts.
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How Is Lyme Arthritis Treated
Most children with Lyme arthritis recover after 28 days of antibiotic treatment. The most common antibiotics prescribed for Lyme disease are:
- Doxycycline for children eight years of age or older
- Amoxicillin for children under eight years of age
If the symptoms persist after a course of antibiotics, a second course of antibiotics may be prescribed.
In persistent cases of Lyme arthritis, your rheumatologist may prescribe non-steroidal anti-inflammatory drugs , disease-modifying antirheumatic drugs , or intra-articular corticosteroids.
Arthritis After Lyme Disease
Lyme disease is an illness spread through ticks saliva. If an infected tick bites you, bacteria in the saliva enters your bloodstream, increasing your risk of Lyme disease.
When there is a delay in treatment, the bacteria may settle into the joints, leading to a special type of arthritis. In fact, six out of 10 people who do not receive timely treatment for Lyme disease develop arthritis.
At Aurora Health Care, our experts quickly and accurately diagnose arthritis after Lyme disease using blood tests and a physical exam. In most cases, youll receive care from a primary care doctor or arthritis expert . But if the arthritis is advanced, an orthopedic specialist may be involved in your care. Learn more about how orthopedics and primary care work together for your care at Aurora.
Most people can make a full recovery after simple treatments, like antibiotics. But if your body needs help to heal, we offer treatments like physical therapy and minimally invasive surgery if others dont work.
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The Lyme Bacteria Compound That Targets Your Joints
Brandon Jutras, a biochemist from Virginia Tech, just figured out why the bacteria behind Lyme disease causes arthritis and other problems
As this bacteria spreads, it releases something called peptidoglycan. Peptidoglycan is found in the cell walls of many bacteria. Unfortunately, peptidoglycan triggers an inflammatory response in the body. This response could be what causes Lyme arthritis, according to Jutras.
In his research, Jutras found peptidoglycan in the joint fluid of people who were exposed to Lyme disease but didnt have an active, detectable Lyme disease infection anymore. They did, however, have inflamed joints and other symptoms of Lyme disease arthritis.
Like I mentioned above, peptidoglycan triggers an inflammatory response in the body. Thats because the immune system knows it comes from bacteria, so it tries to eradicate it. How severely the body responds to peptidoglycan varies from individual to individual.
Why is this discovery important?
For two reasons first, researchers could work on Lyme disease treatments that target peptidoglycan. Second, peptidoglycan could be a way to diagnose chronic Lyme conditions like arthritis. If doctors detect peptidoglycan in your joint fluid, theres a good chance your arthritis symptoms are the result of chronic Lyme.
Lyme Disease And Joint Pain: Its Complicated
For starters, Lyme is complicated and every patient responds to the disease differently.
Approximately 30,000 new cases of Lyme are diagnosed each year, according to the CDC, and just over one-third of them develop arthritis as a symptom. The most common symptoms beyond the bullseye rash are chills, fatigue, headache/neck stiffness, fever. Painful and swollen jointsespecially in large joints such as the kneeare often considered a late-stage symptom of Lyme, but can appear even days after the tick bite.1-3 Some individuals may find out they have Lyme as a result of chronic joint painwithout ever knowing they had a tick bite.
Ticks rarely carry just one strain of bacteria. They usually deliver several different species of bacteria and parasites in one bite these are called co-infections. Co-infections are one reason Lyme disease diagnosis and treatment can be so complex and difficult.
To investigate why joint pain is a common symptom of Lyme disease, I spoke to Thalia Farshchian, ND, a naturopathic doctor practicing at Medical Options for Wellness, a clinic in Foster City, California. She specializes in treating patients affected by chronic and complex diseases, including Lyme disease.
It is estimated that about 70% of individuals presenting with bullseye rash do not recall a tick bite,” she said. “It is important to note that the absence of a rash does not rule out Lyme Disease as diagnosis, but may be supportive of the diagnosis.”
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Lyme Disease: A Cause Of Fibromyalgia Chronic Fatigue And Arthritis
Lyme Disease: a cause of fibromyalgia, chronic fatigue and arthritisBy Nicola McFadzean, N.D.
Lyme disease was once thought of as an obscure disease that only affected people living in the northeast. Increasingly, however, Lyme disease is showing itself to be more prevalent than ever, and more widespread throughout the country, and indeed the world.
The number of Lyme disease cases is difficult to estimate because of both unreported and undiagnosed cases. The number of reported cases exceeds 20,000 per year, and climbing sharply, while the estimate of actual cases is approximately 100,000 per year.
The primary organism behind Lyme disease is a spirochete called Borrelia burgdorferi. A spirochete is a type of bacteria that is long, slender, and assumes a spiral shape. Tick bites are one of the more common routes of transmission however, more recent research has shown that mosquitoes can transmit the Borrelia spirochetes. Lyme frequently appears in multiple members of the family but can present differently. For example, a child has autism, while his mother has fibromyalgia. Both may test positive for Lyme disease.
Many individuals with chronic Lyme disease have other health issues that must be addressed alongside treating the spirochete itself. Among these issues are mold toxicity, parasite infections in the gut, heavy metal toxicity and hormone imbalance. Natural remedies can be used effectively to address the majority of those issues.
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Lyme Disease Often Leads To Lyme Arthritis
Although Lyme disease may affect many organs, such as the heart and nervous system, joint involvement tends to be the most common and persistent manifestation, resulting in joint swelling and pain. About 60% of people who are infected with Lyme develop arthritis unless they receive antibiotics.
In most, Lyme arthritis resolves after 30 days of treatment with an oral antibiotic, such as doxycycline or amoxicillin. Individuals with persistent symptoms despite an oral antibiotic usually respond to treatment with an intravenous antibiotic for 30 days. However, about 10% of those with Lyme arthritis fail to respond to antibiotic treatment, for reasons that have long been unclear.
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