LYME ARTHRITIS IN EUROPEAN CHILDREN AND ADOLESCENTS

Objective. To evaluate and describe Lyme arthritis in European childre n and adolescents. Methods. This was a prospective multicenter study. The diagnosis of Lyme arthritis required the exclusion of other diseas es and positive findings on serology for IgG antibodies to Borrelia bu rgdorferi. Enzyme-linked immunosorbent assay, immunoblotting, and poly merase chain reaction techniques to identify infection by B burgdorfen i were used. Results. Among 62 children and adolescents with Lyme arth ritis, only 1 had a preceding erythema migrans. Arthritis was episodic in 62% and was chronic at onset in 18%. The most common manifestation was monarthritis of the knee. Joint involvement in patients with olig oarthritis was predominantly unilateral or symmetric. Arthralgia was v ery rare. Treatment with 1 or 2 courses of different antibiotics resul ted in disappearance of the arthritis in 77% of the patients. Conclusi on, The clinical presentation of Lyme arthritis in children Is differe nt from that in adults. The calculated incidence of Lyme arthritis in persons under the age of 17 years (4/100,000) exceeds previous estimat ions.