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John Miller, MD
Assistant Professor of Medicine @HopkinsMedicine
#LymeDiseaseAwarenessMonth
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John Miller, MD talking about Lyme arthritis
Assistant Professor of Medicine @HopkinsMedicine
#LymeDiseaseAwarenessMonth
John Miller, MD
Early Lyme arthritis
#LymeDiseaseAwarenessMonth
John Miller, MD
Left untreated Lyme can result in late Lyme arthritis
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John Miller, MD
Late Lyme arthritis may have high IgG although it is only about 60% sensitive. also can test for positive synovial fluid. A negative test does not rule out Lyme arthritis.
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John Miller, MD
Lyme arthritis typically responds well to antibiotics. May require repeat courses, changing Abx and/or IV antibiotics.
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John Miller, MD
We typically site that 90% of patients have "resolution" of Lyme arthritis, however about 25-30% of those patients have continued pain.
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John Miller, MD
In an ideal situation you follow these patients closely and immediately give additional courses of antibiotics if patient has continued symptoms .
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John Miller, MD
Over time with Lyme arthritis we want to see reduced inflammation over time.
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John Miller, MD
1/3 of patients treated for Lyme arthritis will have continued pain. Synovectomy not performed as much anymore.
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John Miller, MD
HLA-DR4 is a predictor of persistent Lyme arthritis
#LymeDiseaseAwarenessMonth
John Miller, MD
Hopkins is looking at markers for persistent Lyme arthritis.
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John Miller, MD
Polyarticular Lyme arthritis, psoriatic arthritis and other forms of arthritis develops relatively quickly after treatment for Lyme
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John Miller, MD
The numbers of Lyme arthritis (darkest band at bottom) is increasing over time.
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John Miller, MD
Inflammatory markers for Lyme arthritis
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John Miller, MD
Tender sites for diagnosing Lyme arthritis overlaps with fibromyalgia. Very difficult to differentiate between these conditions.
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