Is it Lyme Nephritis or Leptospirosis?

摘要

Just because the dog is a Lyme-positive retriever with proteinuria and hypoalbuminemia does not mean it has Lyme nephritis. It could have another cause for protein-losing nephropathy (PLN) or even have a tubular disease such as leptospirosis, which can mimic PLN in many ways and is also seen in Lyme-endemic regions.Misdiagnosis may occur because so many healthy (and sick) dogs are coincidentally Lyme-seropositive, and because Lyme nephritis is difficult to study because there is no experimental model for it. Lyme nephritis is difficult to prove because even if a renal biopsy shows immune-complex glomerulonephritis (ICGN), there are no validated stains to prove the immune-complexes are Lyme-specific antigen-antibody complexes. Here we will discuss the many ways that Lyme nephritis and leptospirosis may mimic one another, and how we might try to sort things out.