POSITIVE SEROLOGY FOR LYME BORRELIOSIS IN PATIENTS WITH JUVENILE RHEUMATOID-ARTHRITIS IN A LYME BORRELIOSIS ENDEMIC AREA - ANALYSIS BY IMMUNOBLOT

Juvenile rheumatoid arthritis (JRA) and the arthritis of Lyme borrelio sis in children can mimic each other. As false positive reactions are frequent in ELISA for Lyme borreliosis, they cannot be used reliably t o make the distinction. Ninety-nine children diagnosed as having JRA a t a children's hospital in an endemic area were evaluated by ELISA and immunoblot for antibodies to Borrelia burgdorferi. Sera from 9% were positive by ELISA, 5 of which showed bands on immunoblot. None met cri teria for positive immunoblot. The antigenic basis of false positive E LISA was most frequently a reactivity to both 21 and 41 kDa. Analysis by immunoblot can help to definitively exclude Lyme borreliosis in chi ldren presenting with JRA in an endemic area.