When a patient suspected with juvenile idiopathic arthritis turns out to be diagnosed with an infectious disease – a review of Lyme arthritis in children
Abstract The Lyme arthritis is a common manifestation of infection with Borrelia burgdorferi spirochete. Despite its infectious background, the inflammation clinically and histopatologically resembles juvenile idiopathic arthritis. As it affects a considerable number of Lyme disease patients, it sho...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
BMC
2017-05-01
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| Series: | Pediatric Rheumatology Online Journal |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12969-017-0166-0 |
| _version_ | 1819151221260288000 |
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| author | Krzysztof Orczyk Joanna Świdrowska-Jaros Elżbieta Smolewska |
| author_facet | Krzysztof Orczyk Joanna Świdrowska-Jaros Elżbieta Smolewska |
| author_sort | Krzysztof Orczyk |
| collection | DOAJ |
| description | Abstract The Lyme arthritis is a common manifestation of infection with Borrelia burgdorferi spirochete. Despite its infectious background, the inflammation clinically and histopatologically resembles juvenile idiopathic arthritis. As it affects a considerable number of Lyme disease patients, it should be routinely considered in differential diagnosis. Development of arthritis is partially dependent on spirochetal factors, including the ribosomal spacer type and the sequence of outer surface protein C. Immunological background involves Th1-related response, but IL-17 provides an additional route of developing arthritis. Autoimmune mechanisms may lead to antibiotic-refractory arthritis. The current diagnostic standard is based on a 2-step testing: ELISA screening and immunoblot confirmation. Other suggested methods contain modified two-tier test with C6 ELISA instead of immunoblot. An initial 28-day course of oral antibiotics (doxycycline, cefuroxime axetil or amoxicillin) is a recommended treatment. Severe cases require further anti-inflammatory management. Precise investigation of new diagnostic and therapeutic approaches is advisable. |
| first_indexed | 2024-12-22T14:29:57Z |
| format | Article |
| id | doaj.art-7c0e0735d43d46f782b902248813b8e1 |
| institution | Directory Open Access Journal |
| issn | 1546-0096 |
| language | English |
| last_indexed | 2024-12-22T14:29:57Z |
| publishDate | 2017-05-01 |
| publisher | BMC |
| record_format | Article |
| series | Pediatric Rheumatology Online Journal |
| spelling | doaj.art-7c0e0735d43d46f782b902248813b8e12022-12-21T18:22:47ZengBMCPediatric Rheumatology Online Journal1546-00962017-05-011511810.1186/s12969-017-0166-0When a patient suspected with juvenile idiopathic arthritis turns out to be diagnosed with an infectious disease – a review of Lyme arthritis in childrenKrzysztof Orczyk0Joanna Świdrowska-Jaros1Elżbieta Smolewska2Department of Pediatric Rheumatology, Medical University of LodzDepartment of Pediatric Rheumatology, Medical University of LodzDepartment of Pediatric Rheumatology, Medical University of LodzAbstract The Lyme arthritis is a common manifestation of infection with Borrelia burgdorferi spirochete. Despite its infectious background, the inflammation clinically and histopatologically resembles juvenile idiopathic arthritis. As it affects a considerable number of Lyme disease patients, it should be routinely considered in differential diagnosis. Development of arthritis is partially dependent on spirochetal factors, including the ribosomal spacer type and the sequence of outer surface protein C. Immunological background involves Th1-related response, but IL-17 provides an additional route of developing arthritis. Autoimmune mechanisms may lead to antibiotic-refractory arthritis. The current diagnostic standard is based on a 2-step testing: ELISA screening and immunoblot confirmation. Other suggested methods contain modified two-tier test with C6 ELISA instead of immunoblot. An initial 28-day course of oral antibiotics (doxycycline, cefuroxime axetil or amoxicillin) is a recommended treatment. Severe cases require further anti-inflammatory management. Precise investigation of new diagnostic and therapeutic approaches is advisable.http://link.springer.com/article/10.1186/s12969-017-0166-0Lyme arthritisLyme diseasePathogenesisSymptomsTreatment |
| spellingShingle | Krzysztof Orczyk Joanna Świdrowska-Jaros Elżbieta Smolewska When a patient suspected with juvenile idiopathic arthritis turns out to be diagnosed with an infectious disease – a review of Lyme arthritis in children Pediatric Rheumatology Online Journal Lyme arthritis Lyme disease Pathogenesis Symptoms Treatment |
| title | When a patient suspected with juvenile idiopathic arthritis turns out to be diagnosed with an infectious disease – a review of Lyme arthritis in children |
| title_full | When a patient suspected with juvenile idiopathic arthritis turns out to be diagnosed with an infectious disease – a review of Lyme arthritis in children |
| title_fullStr | When a patient suspected with juvenile idiopathic arthritis turns out to be diagnosed with an infectious disease – a review of Lyme arthritis in children |
| title_full_unstemmed | When a patient suspected with juvenile idiopathic arthritis turns out to be diagnosed with an infectious disease – a review of Lyme arthritis in children |
| title_short | When a patient suspected with juvenile idiopathic arthritis turns out to be diagnosed with an infectious disease – a review of Lyme arthritis in children |
| title_sort | when a patient suspected with juvenile idiopathic arthritis turns out to be diagnosed with an infectious disease a review of lyme arthritis in children |
| topic | Lyme arthritis Lyme disease Pathogenesis Symptoms Treatment |
| url | http://link.springer.com/article/10.1186/s12969-017-0166-0 |
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