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What Are The Symptoms Of Lyme Disease?
Question: 24yo patient with severe morning hand/arm parathesias (esp. 4-8am), insomnia (3--4hr/nite), weakness/fatigue, intermittent headache with photophobia (no hx of migraine), intermittent tachycardia, muscle "freezing"/soreness x3wks. (also wt loss but intentionally losing wt so unable to ascertain relationship) Symptoms started after a rash was identified as contact dermatitis (poison ivy?) and treated with steroid shot and 2days prednisone. Thyroid and adrenal labs negative.
No known vector/bites but could this be Lyme disease? Other ID disease? Other thoughts?
No known vector/bites but could this be Lyme disease? Other ID disease? Other thoughts?
Brief Answer:
Possibility of hyperthyroidism, SLE or Lyme's ds
Detailed Answer:
Hello,
Thanks for posting your query on HealthcareMagic.
The symptoms of paresthesia, insomnia, headache, photophobia, tachycardia, soreness, weight loss are a rash can be a part of one disease process or can be different entities.
However, the possibility of latter is more likely.
The possibilities that come to me after analysis you symptoms are:
1. Hyperthyroidism
2. Systemic lupus erythematosus (SLE)
3 Lyme's disease
The thyroid function tests have come to be negative as mentioned by you, however, still I would suggest you to get thyroid function test and this time only TSH levels.
SLE is an autoimmune disease more common in females and tends to involve multiple organ systems.
The investigation done for SLE is anti nuclear antibody (ANA) and anti double stranded DNA antibodies (ant dsDNA).
The third possibility which of course you too are suspicious is that of Lyme's disease.
However, a history of tick bite has to be there in Lyme's disease.
Anyhow, a serological test for Lyme's disease can be done to diagnose or rule out the infection.
Further management can be planned after getting these investigations.
If you have more queries, I will be glad to answer.
Dr Shailja P Wahal
Possibility of hyperthyroidism, SLE or Lyme's ds
Detailed Answer:
Hello,
Thanks for posting your query on HealthcareMagic.
The symptoms of paresthesia, insomnia, headache, photophobia, tachycardia, soreness, weight loss are a rash can be a part of one disease process or can be different entities.
However, the possibility of latter is more likely.
The possibilities that come to me after analysis you symptoms are:
1. Hyperthyroidism
2. Systemic lupus erythematosus (SLE)
3 Lyme's disease
The thyroid function tests have come to be negative as mentioned by you, however, still I would suggest you to get thyroid function test and this time only TSH levels.
SLE is an autoimmune disease more common in females and tends to involve multiple organ systems.
The investigation done for SLE is anti nuclear antibody (ANA) and anti double stranded DNA antibodies (ant dsDNA).
The third possibility which of course you too are suspicious is that of Lyme's disease.
However, a history of tick bite has to be there in Lyme's disease.
Anyhow, a serological test for Lyme's disease can be done to diagnose or rule out the infection.
Further management can be planned after getting these investigations.
If you have more queries, I will be glad to answer.
Dr Shailja P Wahal
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Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
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