PEDIATRIC LYME ARTHRITIS - CLINICAL SPECTRUM AND OUTCOME

A cohort of children with Lyme arthritis was used to evaluate the clin ical and serologic profile of the disease. During a 42-month period (J une 1989 to December 1991), 44 patients (13 girls and 31 boys, ages 4- 18 years) were included and followed for 6-36 months. Inclusion requir ed the presence of arthritis, as well as positive serology. Thirty-fou r children with juvenile rheumatoid arthritis or spondyloarthropathy w ere used as a serologic comparison group. Five different patterns of a rthritis were found. Preceding erythema migrans was seen in seven chil dren. Antinuclear antibodies were positive in 30% of the patients. Thr ee treatments were used and selected according to physician preference , patient age, and presence of extraarticular disease: amoxicillin, do xycycline, and ceftriaxone. Articular disease reached complete resolut ion in all patients within 2-12 weeks. Lyme arthritis in children may mimic other pediatric arthritides. Prognosis for children with clearly defined