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Scientists dont exactly know why this reaction happens but suspect that one reason is that the killed spirochetes break down and release toxins, and our immune systems response to this spill is what causes the symptoms of the Jarisch Herxheimer reaction
Duloxetine significantly reduces pain scores and improves functional outcomes
Simultaneously, activation of the intrarenal reninangiotensin system (RAS) induces efferent arteriolar vasoconstriction (48)
doi: 10.1136/bmj.k2932 20
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