Key Difference – Lyme Disease vs Lupus
Lupus and Lyme disease are two diseases sharing many common symptoms. Although it is easy for a clinician to identify the difference between Lyme disease and lupus with a proper history and a few standard investigations, for the ordinary public, the similarity in the manner of presentation can be a cause of confusion.Lupus is basically anautoimmune diseasewith systemic manifestations; therefore, it has an endogenous origin. But Lyme disease is aninfectious disease由a引起病原那通过滴答叮咬进入我们的身体。因此,莱姆病是由外部药物引起的一种外源性疾病。这是莱姆病和狼疮之间的关键区别。
CONTENTS
1.Overview and Key Difference
2.What is Lyme Disease
3.什么是狼疮
4.Similarities Between Lyme Disease and Lupus
5.并排比较 - 表格形式的莱姆病与狼疮
6.Summary
What is Lyme Disease?
In an overwhelming majority of the cases, Lyme disease is caused by a spirochete namedBorrelia Burgdoferi通过叮咬进入人体liceorticks。另一个不太频繁遇到的因果剂是B.AfzelliandB.garinii.
感染的水库是ixodid(硬滴答),它以许多大型哺乳动物为食。鸟类还负责这些寄生虫在生态系统中的传播。如前所述,螺旋体进入了人类的血液,后者是一口tick虫,其成年,幼虫和若虫阶段具有传播感染的能力。
大多数患有莱姆病的患者都倾向于将ehrllichipois作为共同感染。
Clinical Features
The disease progression happens in three stages and the clinical features vary depending on the stage.
Early Localized Stage
定义这一初始阶段的最独特功能是在tick叮咬位置周围的皮肤反应出现,称为红斑迁移。tick咬伤后约2-30天,可能会出现黄斑或丘疹皮疹。皮疹通常起源于与tick咬相邻的区域,然后在周围散布。这些皮肤lesionshave a characteristic bull’s eye appearance with a central clearing. However, these features are not pathognomonic of the Lyme disease. It is possible to have minor general symptoms such as fever, lymphadenopathy, and fatigue during this stage.
早期传播疾病
从原始现场传播感染的传播是通过blood and lymph。As the body starts to respond to this, the patient may complain of mild arthralgia and, malaise. In some occasions, development of metastatic erythema migrans can be seen. Neurological involvement becomes apparent usually few months after the initial infection and is confirmed by the occurrence of lymphocyticmeningitis,颅神经麻痹和周围神经病。莱姆病相关的心脏炎和根瘤病的发生率取决于某些流行病学因素。
Late Disease
Arthritis影响大关节,多神经炎和脑病是该疾病后期经常看到的临床特征。由于脑实质的参与,可能引起神经精神病问题。慢性炎性萎缩性萎缩性是晚期莱姆病的罕见并发症。
Diagnosis
在疾病的最初阶段,可以根据临床特征和病史进行诊断。从活检样品中培养生物体通常不是可靠的,而且很耗时(因为该过程至少需要六个星期才能获得令人满意的结果)。
Antibody detection is not useful right at the onset of the disease but gives extremely accurate results during the early disseminated and late stages.
高级技术(例如PCR)的可用性增加,加快了莱姆病的诊断和治疗过程,最大程度地减少了威胁生命的并发症。
Management
- 最新的指南建议不要治疗无症状的抗体测试结果。
- Standard therapy consists of a 14-day course of doxycycline (200 mg daily) or amoxicillin (500 mg 3 times daily). But in case of the disseminated disease with arthritis, the therapy should be extended to 28 days.
- 任何神经元的参与都应通过肠胃外βlacTAMS进行3-4周来管理。
预防
- Use of protective clothing
- 驱虫剂
- The risk of infection in the first few hours of the tick bite is considerably low. Therefore, removal of the tick immediately decreases the chance of any advanced disease.
什么是狼疮?
狼疮是一种具有全身作用的自身免疫性疾病。它也被称为疾病,有一千个面孔,因为它可以表现出多种方式。
四个major clinical variants of lupus erythematosus have been described.
- 系统性红斑狼疮
- 盘状(新生儿)红斑狼疮
- Subacute cutaneous
- Systemic
Systemic Lupus Erythematosus (SLE)
This is the commonest clinical variant of lupus. At least four of the following criteria have to be fulfilled to make a diagnosis of SLE
- Malar rash
- 光敏性
- 盘状斑块
- Arthritis
- 口腔溃疡
- Renal changes
- 血清炎
- 神经学的参与
- 血液学变化
- 免疫学变化
- 抗核抗体
The incidence of SLE among females is much higher than that among males.The presence of a malar rash is the unique feature that persuades a clinician to suspect SLE. Although not mandatory, SLE patients can also have vasculitis. Lupus associated fever and arthritis are the other commonly seen clinical features.
Discoid Lupus Erythematosus
The presence of antinuclear antibodies is very rare in this condition. The patient usually describes a nutmeg grater like feel due to hyperkeratosis and atrophy of the hair follicles. These skin changes are results of the inflammatory lesions that are triggered by the exposure to sunlight. Therefore, these skin changes predictably aggravate during the summer.
SLE的诊断
当上述临床标准导致临床医生怀疑狼疮时,进行了测试和研究以确认诊断。
- Serum肌酐和尿液分析以评估肾功能
- CBC差异
- ESR or CRP
- 肝功能测试
- Autoantibody tests
- 联合X射线照相
- 超声心动图
- Chest radiography
- 关节色素
- Renal biopsy
Treatment
The following drugs are used in the management of SLE
- 抗疟疾
- 用于控制潜在炎症的抗炎皮质类固醇。易经随访是为了避免与长期使用皮质类固醇相关的并发症。
- NSAIDS
- Disease Modifying Anti Rheumatic Drugs
What are the Similarities Between Lyme Disease and Lupus
莱姆病和狼疮具有许多常见的临床特征,例如关节炎,发烧,头痛。
在两种情况下都可以看到中枢神经系统的参与。
What is the Difference Between Lyme Disease and Lupus?
Lyme Disease vs Lupus |
|
莱姆病是一种自身免疫性疾病。 | Lupus is an infectious disease. |
Arthritis | |
Lyme disease associated arthritis mainly affects the large joints. | Lupus associated arthritis affects the small joints. |
Fever | |
发烧通常发生在疾病的早期。 | 在疾病进展的所有阶段,发烧都不可差。 |
疟疾皮疹 | |
Malar rash is not seen. Instead, erythema migrans is present as the characteristic feature. | 疟疾皮疹被视为独特的临床特征。 |
Summary – Lyme Disease vs Lupus
红斑狼疮和莱姆病独特的皮肤manifestations that help in differentiating them from one another. The origin of the two conditions is the main difference between Lyme disease and lupus. Lupus is an autoimmune disease that arises as a result of the production of autoantibodies. But Lyme disease is an infectious disease caused byBorrelia Burgdoferi。
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参考:
1. Colledge, Nicki R, Brian R. Walker, Stuart Ralston, and Stanley Davidson. Davidson’s Principles and Practice of Medicine. Edinburgh: Churchill Livingstone/Elsevier, 2010. Print.
Image Courtesy:
1. “Bullseye Lyme Disease Rash” By Hannah Garrison – en:User:Jongarrison(CC BY-SA 2.5)viaCommons Wikimedia
2. “Lupusfoto” By Doktorinternet – Own work(CC BY-SA 4.0)viaCommons Wikimedia
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