Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
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Advances in Clinical and Experimental Medicine

2008, vol. 17, nr 6, November-December, p. 635–641

Publication type: original article

Language: English

Non−Specific Arthralgia as the Main Manifestation of Borrelia burgdorferi Sensu Lato Infection

Nieswoiste bóle stawowe jako główny objaw kliniczny zakażenia krętkami Borrelia burgdorferi sensu lato

Anna Duda1,, Urszula Kasprzykowska1,, Beata Sobieszczańska1,

1 Department of Microbiology, Silesian Piasts University of Medicine in Wrocław, Poland

Abstract

Background. In European countries, muscoskeletal symptoms associated with Lyme arthritis appear in 7–20% of disseminated cases of borreliosis. Lyme arthritis is a late manifestation of the disease; however, like erythema migrans, arthritis may occur as the only or the initial manifestation of infection with Borrelia burgdorferi sensu lato.
Objectives. The present study was carried out to determine seroreactivity to B. burgdorferi sensu lato antigens in inhabitants of the Lower Silesian region of Poland suffering from undiagnosed arthralgia.
Material and Methods. To detect IgM and IgG antibodies specific to B. burgdorferi sensu lato in sera, an immunoenzyme assay with recombinant antigens was performed. All immunoenzyme assay−positive samples were confirmed by Western blot.
Results. Immunoenzyme assay followed by Western blot analysis revealed that of 64 serum samples examined, 23 (35.9%) demonstrated the presence of IgM and/or IgG antibodies confirmed by reactivity with antigens specific to B. burgdorferi sensu lato. The results allow assuming that at least 9 (14.1%) subjects with IgG or IgG and IgM immune responses present active Lyme arthritis.
Conclusion. The results strongly suggest that in the wooded region of Lower Silesia, arthralgia should be diagnosed paying special attention to Lyme disease at least in subjects with a history of tick bite.

Streszczenie

Wprowadzenie. W krajach europejskich objawy kostno−stawowe związane z chorobą z Lyme dotyczą 7–20% przypadków rozsianej boreliozy. Boreliozowe zapalenie stawów dotyczy przewlekłej boreliozy, ale podobnie jak rumień migrujący, może być wczesnym, a czasem jedynym objawem zakażenia krętkami Borrelia burgdorferi sensu lato.
Cel pracy. Zbadanie obecności przeciwciał dla antygenów Borrelia burgdorferi sensu lato w surowicach mieszkańców Dolnego Śląska cierpiących z powodu nieokreślonych bólów stawowych, którzy w przeszłości mieli kontakt z kleszczami.
Materiał i metody. Przeciwciała swoiste dla Borrelia burgdorferi sensu lato oznaczano testem immunoenzymatycznym z rekombinowanymi antygenami, a następnie ich obecność potwierdzano testem Western blot.
Wyniki. Obecność przeciwciał klas IgM i/lub IgG swoistych dla Borrelia burgdorferi sensu lato wykryto w 23 (35,9%) spośród 64 badanych surowic. Uzyskane wyniki badań pozwalają przypuszczać, że co najmniej 9 (14,1%) badanych seropozytywnych osób prezentowało aktywną postać boreliozowego zapalenia stawów.
Wnioski. Nierzadkie na zalesionym terenie Dolnego Śląska zakażenie krętkami z gatunku Borrelia burgdorferi sensu lato powinno być brane pod uwagę w różnicowej diagnostyce bólów stawowych.

Key words

arthralgia, Lyme arthritis, Borrelia burgdorferi sensu lato, serological tests, recombinant antigens

Słowa kluczowe

ból stawu, boreliozowe zapalenie stawów, Borrelia burgdorferi sensu lato, testy serologiczne, antygeny rekombinowane

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