Huppertz H I, Karch H
Universitäts-Kinderklinik, Würzburg.
Monatsschr Kinderheilkd. 1991 Nov;139(11):759-64.
Four children with monarthritis of the knee had no further manifestations of Lyme borreliosis, but a positive antibody titer against Borrelia burgdorferi as measured by Elisa. About 3 years after antibiotic therapy none of the children had arthritis, but one suffered from fibromyalgia and another child had still a vigorous reactivity against Borrelia burgdorferi antigens by Elisa and immunoblot. In this study 4 out of 20 children with recently recognized arthritis had Lyme arthritis which makes it a rather frequent disease. The clinical presentation could not distinguish these 4 children from 4 other children with monarthritis of the knee of unknown origin. In the absence of better diagnostic criteria, the association of monarthritis, not otherwise explained, with a positive Lyme serology seems to be sufficient evidence to establish a diagnosis of Lyme arthritis. After confirmation of the diagnosis children should be treated without delay.
4名患膝单关节炎的儿童没有莱姆病的进一步表现，但通过酶联免疫吸附测定法检测出抗伯氏疏螺旋体的抗体效价呈阳性。抗生素治疗约3年后，这些儿童均未患关节炎，但有1名儿童患纤维肌痛，另1名儿童通过酶联免疫吸附测定法和免疫印迹法对伯氏疏螺旋体抗原仍有强烈反应。在本研究中，20名近期确诊患关节炎的儿童中有4名患莱姆关节炎，这使其成为一种相当常见的疾病。临床表现无法将这4名儿童与另外4名病因不明的膝单关节炎儿童区分开来。在缺乏更好的诊断标准的情况下，无法作出其他解释的单关节炎与莱姆血清学阳性之间的关联似乎足以确诊莱姆关节炎。确诊后应立即对儿童进行治疗。
