Zusammenfassung
Die Lyme-Arthritis ist eine Manifestation der durch die Infektion mit Borrelia burgdorferi sensu lato verursachten Lyme-Borreliose. In dieser Arbeit werden die aktuellen Erkenntnisse zur Epidemiologie, Ätiologie und Pathogenese sowie zu den klinischen Manifestationen und deren Diagnose, Behandlung und Prognose dargestellt, unter besonderer Berücksichtigung des Kinder- und Jugendalters.
Abstract
Lyme arthritis is one of the manifestations of Lyme disease and is caused by infection with Borrelia burgdorferi sensu lato. This article reviews the current knowledge regarding the epidemiology, etiology and pathogenesis as well as the clinical manifestations, the diagnosis, treatment and prognosis with special emphasis on children and adolescents.
Literatur
Huppertz HI, Dressler F (2005) Lyme disease. In: Cassidy JT, Petty RE, Laxer RM, Lindsley CB (eds) Textbook of Pediatric Rheumatology. 5th edn. Elsevier Saunders, Philadelphia, pp 591–603
Huppertz HI (1990) Childhood Lyme borreliosis in Europe. Eur J Pediatr 149: 814–821
Dressler F (1994) Lyme borreliosis in European children and adolescents. Clin Exp Rheumatol (Suppl 10) 12: S49
Berglund J, Eitrem R, Ornstein K et al. (1995) An epidemiologic study of Lyme disease in Southern Sweden. N Engl J Med 333: 1319–1327
Huppertz HI, Böhme M, Standaert SM et al. (1999) Incidence of Lyme borreliosis in the Würzburg region of Germany. Eur J Clin Microbiol Infect Dis 18: 697–703
Gerber MA, Shapiro ED, Burke GS et al. (1996) Lyme disease in children in southeastern Connecticut. N Engl J Med 335: 1270–1274
Huppertz HI, Karch H, Suschke HJ et al. (1995) Lyme arthritis in European children and adolescents. Arthritis Rheum 38: 361–368
Richter D, Postic D, Sertour N et al. (2006) Delineation of Borrelia burgdorferi sensu lato species by multilocus sequence analysis and confirmation of the delineation of Borrelia spielmanii sp. Nov. Int J Syst Evol Microbiol 56: 873–881
Fraser CM, Casjens S, Huang WM et al. (1997) Genomic sequence of a Lyme disease spirochaete, Borrelia burgdorferi. Nature 390: 580–586
Coburn J, Magoun L, Bodary SC et al. (1998) Integrins alpha(v)beta3 and alpha5beta1 mediate attachment of Lyme disease spirochetes to human cells. Infect Immun 66: 1946–1952
Girschick HJ, Huppertz HI, Rüssmann H et al. (1996) Intracellular persistence of Borrelia burgdorferi in human synovial cells. Rheumatol Int 16: 125–132
Gross DM, Steere AC, Huber BT (1998) T helper 1 response is dominant and localized to the synovial fluid in patients with Lyme arthritis. J Immunol 160: 1022–1028
Busch DH, Jassoy C, Brinckmann U et al. (1996) Detection of Borrelia burgdorferi–specific CD8 cytotoxic T-cells in patients with Lyme arthritis. J Immunol 157: 3534–3541
Roessner K, Wolfe J, Shi C et al. (2003) High expression of Fas ligand by synovial fluid-derived γδ-T cells in Lyme arthritis. J Immunol 170: 2702–2710
Shin JJ, Glickstein LJ, Steere AC (2007) High levels of inflammatory chemokines and cytokines in joint fluid and synovial tissue throughout the course of antibiotic-refractory Lyme arthritis. Arthritis Rheum 56: 1325–1335
Weigelt W, Schneider T, Lange R (1992) Sequence homology between spirochaete flagellin and human myelin basic protein. Immunol Today 13: 279–280
Sigal LH (1993) Cross-reactivity between Borrelia burgdorferi flagellin and a human axonal 64000 molecular weight protein. J Infect Dis 167: 1372–1378
Kalish R, Leong JM, Steere AC (1993) Association of treatment-resistant chronic Lyme arthritis with HLA-DR4 and antibody reactivity to OspA and OspB of Borrelia burgdorferi. Infect Immun 61: 2774–2779
Kamradt T, Lengl-Janssen B, Strauss AF et al. (1996) Dominant recognition of a Borrelia burgdorferi outer surface protein A peptide by T helper cells in patients with treatment-resistant Lyme arthritis. Infect Immun 64: 1284–1289
Drouin EE, Glickstein L, Kwok WW et al. (in press) Human homologues of a Borrelia T cell epitope associated with antibiotic-refractory Lyme arthritis. Mol Immunol: Epub ahead of print
Gross DM, Forsthuber T, Tary-Lehmann M et al. (1998) Identification of LFA-1 as a candidate autoantigen in treatment-resistant Lyme arthritis. Science 281: 703–706
Steere AC, Falk B, Drouin EE et al. (2003) Binding of outer surface protein A and human lymphocyte function-associated antigen 1 peptides to HLA-DR molecules associated with antibiotic treatment-resistant Lyme arthritis. Arthritis Rheum 48: 534–540
Huppertz HI, Karch H (1991) Die Lyme-Arthritis im Kindesalter: Monarthritis des Kniegelenks, klinisch nicht unterscheidbar von Monarthritiden unbekannter Ursache. Monatsschr Kinderheilkd 139: 759–764
Hammers-Berggren S, Andersson U, Stiernstedt G (1992) Borrelia arthritis in Swedish children: clinical manifestations in 10 children. Acta Paediatr 81: 921–924
Gerber MA, Zemel LS, Shapiro ED (1998) Lyme arthritis in children: clinical epidemiology and long-term outcomes. Pediatrics 102: 905–908
Huppertz HI, Michels H (1996) Pattern of joint involvement in children with Lyme arthritis. Br J Rheumatol 35: 1016–1018
Huppertz HI, Münchmeier D, Lieb W (1999) Ocular manifestations in children and adolescents with Lyme arthritis. Br J Ophthalmol 83: 1149–1152
Christoforo RL, Appel MH, Gelb RF, Williams CL (1987) Musculoskeletal manifestations of Lyme disease in children. J Pediatr Orthop 7: 527
Sigal LH, Patella SJ (1992) Lyme arthritis as the incorrect diagnosis in pediatric and adolescent fibromyalgia. Pediatrics 90: 523–528
De Koning J, Bosma RB, Hoogkamp-Korstanje JAA (1987) Demonstration of spirochaetes in patients with Lyme disease with a modified silver stain. J Med Microbiol 23: 261–267
Golightly M (1993) Laboratory considerations in the diagnosis and management of Lyme borreliosis. Am J Clin Pathol 99: 168–174
Nocton JJ, Dressler F, Rutledge BJ et al. (1994) Detection of Borrelia burgdorferi DNA by polymerase chain reaction in synovial fluid from patients with Lyme arthritis. N Engl J Med 330: 229–234
Carlson D, Hernandez J, Bloom BJ et al. (1999) Lack of Borrelia burgdorferi DNA in synovial fluid samples from patients with antibiotic treatment–resistant Lyme arthritis. Arthritis Rheum 42: 2705–2709
Priem S, Rittig MG, Kamradt T et al. (1997) An optimized PCR leads to rapid and highly sensitive detection of Borrelia burgdorferi in patients with Lyme borreliosis. J Clin Microbiol 35: 685–690
Jaulhac B, Chary-Valckenaere I, Sibila J et al. (1996) Detection of Borrelia burgdorferi by DNA amplification in synovial tissue samples from patients with Lyme arthritis. Arthritis Rheum 39: 736–745
Priem S, Burmester GR, Kamradt T et al. (1998) Detection of Borrelia burgdorferi by polymerase chain reaction in synovial membrane, but not in synovial fluid from patients with persisting Lyme arthritis after antibiotic therapy. Ann Rheum Dis 57: 118–121
Karch H, Huppertz HI, Böhme M et al. (1994) Demonstration of Borrelia burgdorferi DNA in urine samples from healthy humans whose sera contain B. burgdorferi–specific antibodies. J Clin Microbiol 32: 2312–2314
(1995) Recommendations for test performance and interpretation from the second national conference on serologic diagnosis of Lyme disease. MMWR Morb Mortal Wkly Rep 44: 590–591
Dressler F, Whalen JA, Reinhardt BN et al. (1993) Western blotting in the serodiagnosis of Lyme disease. J Infect Dis 167: 392–400
Hauser U, Lehnert G, Lobentanzer R et al. (1997) Interpretation criteria for standardized Western blots for three European species of Borrelia burgdorferi sensu lato. J Clin Microbiol 35: 1433–1444
Hauser U, Lehnert G, Wilkske B (1999) Validity of interpretation criteria for standardized Western blots (immunoblots) for serodiagnosis of Lyme borreliosis based on sera collected throughout Europe. J Clin Microbiol 37: 2241–2247
Rose CD, Fawcett PT, Gibney KM et al. (1996) Residual serologic reactivity in children with resolved Lyme arthritis. J Rheumatol 23: 367
Nichol G, Dennis DT, Steere AC et al. (1998) Test-treatment strategies for patients suspected of having Lyme disease: a cost-effectiveness analysis. Ann Intern Med 128: 37–48
Dressler F, Yoshinari NH, Steere AC (1991) The T-cell proliferative assay in the diagnosis of Lyme disease. Ann Intern Med 115: 533–539
Huppertz HI, Mösbauer S, Busch DH et al. (1996) Lymphoproliferative responses to Borrelia burgdorferi in the diagnosis of Lyme arthritis in children and adolescents. Eur J Pediatr 155: 297–302
Holl-Wieden A, Suerbaum S, Girschick HJ (2007) Seronegative Lyme arthritis. Rheumatol Int 27: 1091–1093
Huppertz HI, Bentas W, Haubitz I et al. (1998) Diagnosis of pediatric Lyme arthritis using a clinical score. Eur J Pediatr 157: 304–308
Ecklund K, Vargas S, Zurakowski D, Sundel RP (2005) MRI features of Lyme arthritis in children. AJR Am J Roentgenol 184: 1904–1909
(1990) Case definitions for public health surveillance. MMWR Morb Mortal Wkly Rep 39: 19
Zahid Qureshi M, New D, Zulqarni NJ, Nachman S (2002) Overdiagnosis and overtreatment of Lyme disease in children. Pediatr Infect Dis J 21: 12
Huppertz HI, Karch H, Heesemann J (1995) Diagnostic value of synovial fluid analysis in children with reactive arthritis. Rheumatol Int 15: 167–170
Dattwyler RJ, Volkman DJ, Conaty SM et al. (1990) Amoxicillin plus probenecid versus doxycycline for treatment of erythema migrans borreliosis. Lancet 336: 1404–1406
Dattwyler RJ, Halperin JJ, Volkman DJ et al. (1988) Treatment of late Lyme borreliosis – randomised comparison of ceftriaxone and penicillin. Lancet 1: 1191–1194
Weber K, Preac-Mursic V, Wilske B et al. (1990) A randomized trial of ceftriaxone versus oral penicillin for the treatment of early European Lyme borreliosis. Infection 18: 91–96
Pfister HW, Preac-Mursic V, Wilske B et al. (1989) Cefotaxime versus penicillin G for acute neurologic manifestations in Lyme borreliosis. A prospective randomized study. Arch Neurol 46: 1190–1194
Müllegger RR, Millner MM, Stanek G et al. (1991) Penicillin G sodium and ceftriaxone in the treatment of neuroborreliosis in children – a prospective study. Infection 19: 279–283
Massarotti EM, Luger SW, Rahn DW et al. (1992) Treatment of early Lyme disease. Am J Med 92: 396–403
Eppes SC, Childs JA (2002) Comparative study of cefuroxime axetil versus amoxicillin in children with early Lyme disease. Pediatrics 109: 1173–1177
Dattwyler RJ, Luft BJ, Kunkel MJ et al. (1997) Ceftriaxone compared with doxycycline for the treatment of acute disseminated Lyme disease. N Engl J Med 337: 289
Hansen K, Hovmark A, Lebeque AM et al. (1992) Roxithromycine in Lyme borreliosis: discrepant results of an in vitro and in vivo animal susceptibility study and a clinical trial in patients with erythema migrans. Acta Derm Venerol (Stockh) 72: 297–300
Weber K, Wilske B, Preac-Mursic V et al. (1993) Azithromycin versus penicillin V for the treatment of early Lyme borreliosis. Infection 21: 367
Strle F, Preac-Mursic V, Cimperman J et al. (1993) Azithromycin versus doxycycline for treatment of erythema migrans: clinical and microbiologic findings. Infection 21: 83–88
Luft BJ, Dattwyler RJ, Johnson RC et al. (1996) Azithromycin compared with amoxicillin in the treatment of erythema migrans. A double-blind, randomized, controlled trial. Ann Intern Med 124: 785–791
Steere AC, Levin RE, Molloy PJ et al. (1994) Treatment of Lyme arthritis. Arthritis Rheum 37: 878–888
Wormser GP, Ramanathan R, Nowakowski J et al. (2003) Duration of antibiotic therapy for early Lyme disease. Ann Intern Med 138: 697–704
Thorstrand C, Belfrage E, Bennet R et al. (2002) Successful treatment of neuroborreliosis with ten day regimens. Pediatr Infect Dis J 21: 1142
Eckman MH, Steere AC, Kalish RA et al. (1997) Cost effectiveness of oral as compared with intravenous antibiotic therapy for patients with early Lyme disease or Lyme arthritis. N Engl J Med 337: 357–363
Gasser R, Wendelin I, Reisinger E et al. (1995) Roxithromycin in the treatment of Lyme disease – update and perspectives. Infection (Suppl 1) 23: S39
Bentas W, Karch H, Huppertz HI (2000) Lyme arthritis in children and adolescents: outcome 12 months after initiation of antibiotic therapy. J Rheumatol 27: 2025–2039
American Academy of Pediatrics, Committee on Infectious Diseases (2000) Prevention of Lyme disease. Pediatrics 105: 142
Hayes EB, Piesman J (2003) How can we prevent Lyme disease? N Engl J Med 348: 2424–2430
Fish D (1995) Environmental risk and prevention of Lyme disease. Am J Med (Suppl 4A) 98: 2S–8S
Crippa M, Rais O, Gern L (2002) Investigations on the mode and dynamics of transmission and infectivity of Borrelia burgdorferi sensu stricto and Borrelia afzelii in Ixodes ricinus ticks. Vector Borne Zoonotic Dis 2: 3
Nadelman RB, Nowakowski J, Fish D et al. (2001) Prophylaxis with single-dose doxycycline for the prevention of Lyme disease after an Ixodes scapularis tick bite. N Engl J Med 345: 79–84
Warshafsky S, Nowakowski J, Nadelman RB et al. (1996) Efficacy of antibiotic prophylaxis for prevention of Lyme disease. J Gen Intern Med 11: 329–333
Adams WV, Rose CD, Eppes SC et al. (1999) Cognitive effects of Lyme disease in children: a 4 year followup study. J Rheumatol 26: 1190
Salazar JC, Gerber MA, Goff CW (1993) Long-term outcome of Lyme disease in children given early treatment. J Pediatr 122: 591
Seltzer EG, Gerber MA, Cartter M et al. (2000) Long-term outcomes of persons with Lyme disease. JAMA 283: 609–616
Szer IS, Taylor E, Steere AC (1991) The long-term course of Lyme arthritis in children. N Engl J Med 325: 159–163
Hendrickx G, De Boeck H, Goossens A et al. (2004) Persistent synovitis in children with Lyme arthritis: two unusual cases. An immunogenetic approach. Eur J Pediatr 163: 646–650
Adams WV, Rose CD, Eppes SC, Klein JD (1994) Cognitive effects of Lyme disease in children. Pediatrics 94: 185
Bloom BJ, Wycoff PM, Meissner HC et al. (1998) Neurocognitive abnormalities in children after classic manifestations of Lyme disease. Pediatr Infect Dis J 17: 189–196
Interessenkonflikt
Der korrespondierende Autor gibt an, dass kein Interessenkonflikt besteht.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Dressler, F., Huppertz, HI. Lyme-Arthritis bei Kindern und Jugendlichen. Z. Rheumatol. 67, 121–127 (2008). https://doi.org/10.1007/s00393-007-0245-6
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00393-007-0245-6