Lyme arthritis: linking infection, inflammation and autoimmunity
Nature Reviews Rheumatology, Published online: 05 July 2021; doi:10.1038/s41584-021-00648-5Lyme arthritis, a manifestation of Lyme disease, can sometimes persist in a chronic post-infectious disease. In this Review, the authors argue that post-infectious Lyme arthritis could act as a model to improve understanding of other forms of chronic arthritis.
CONCLUSIONS: The presence of IgG antibodies against a number of Borreliella antigens and the differences in the IL-2 and MMP2 levels in seropositive or seronegative individuals and symptomatic LB patients, may indicate differences in the intensity of the immune response to the infection and, consequently, may induce development of clinical manifestations of the disease in seropositive and seronegative individuals.PMID:34558260 | DOI:10.26444/aaem/124088
Teaching point: Meticulous anamnesis and a high index of suspicion is needed for the diagnosis of Lyme arthritis. Published on 2021-09-21 11:30:32
Lyme disease is the most frequent tick-borne infectious disease in Europe. It often presents with a wide variety of symptoms. For this reason, affection of the temporomandibular joint (TMJ) caused by Lyme dise...
A 50-year-old woman presents with left eye redness and headaches. Her best-corrected visual acuity is 20/20 OD and 20/25 OS. On examination, her left eye has 2 temporal scleral nodules with surrounding hyperemia and no scleromalacia. Laboratory test results show elevated levels of rheumatoid factor and C-reactive protein, and Lyme IgG, IgM, and reflex Western blot assays are positive for antibodies. Further testing shows she is negative for rheumatoid arthritis-associated nodular scleritis; however, new scleral thinning with persistence of the scleral nodules is noted. What would you do next?