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.