Pediatric Lyme arthritis: clinical spectrum and outcome.
A cohort of children with Lyme arthritis was used to evaluate the clinical and serologic profile of the disease. During a 42-month period (June 1989 to December 1991), 44 patients (13 girls and 31 boys, ages 4-18 years) were included and followed for 6-36 months. Inclusion required the presence of arthritis, as well as positive serology. Thirty-four children with juvenile rheumatoid arthritis or spondyloarthropathy were used as a serologic comparison group. Five different patterns of arthritis were found. Preceding erythema migrans was seen in seven children. Antinuclear antibodies were positive in 30% of the patients. Three treatments were used and selected according to physician preference, patient age, and presence of extraarticular disease: amoxicillin, doxycycline, and ceftriaxone. Articular disease reached complete resolution in all patients within 2-12 weeks. Lyme arthritis in children may mimic other pediatric arthritides. Prognosis for children with clearly defined Lyme arthritis was excellent.
Rose
C D
CD
Division of Rheumatology, Alfred I. duPont Institute, Wilmington, Delaware 19899.
Fawcett
P T
PT
Eppes
S C
SC
Klein
J D
JD
Gibney
K
K
Doughty
R A
RA
D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001170:Arthritis, Infectious / Q000188:drug therapy / Q000276:immunology* / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008193:Lyme Disease / Q000188:drug therapy / Q000276:immunology* / Q000503:physiopathology; D008297:Male; D012698:Serologic Tests
D000900:Anti-Bacterial Agents