Diagnosis of paediatric Lyme arthritis using a clinical score
Autor: | C. Schauer-Petrowskaja, Hermann J. Girschick, G. Ganser, Angelika Thon, Kirsten Minden, H.-J. Suschke, H. I. Huppertz, L. Schuchmann, I. Haubitz, W. Bentas |
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Rok vydání: | 1998 |
Předmět: |
Male
medicine.medical_specialty Adolescent Immunoblotting Arthritis Enzyme-Linked Immunosorbent Assay Lyme Arthritis Serology Diagnosis Differential Lyme disease Borrelia burgdorferi Group Internal medicine Clinical investigation medicine Humans Borrelia burgdorferi Prospective cohort study Child Lyme Disease biology business.industry medicine.disease biology.organism_classification Antibodies Bacterial Arthralgia Surgery El Niño ROC Curve Child Preschool Immunoglobulin G Pediatrics Perinatology and Child Health Female business |
Zdroj: | European journal of pediatrics. 157(4) |
ISSN: | 0340-6199 |
Popis: | Diagnosis of Lyme arthritis (LA) in children and adolescents may be difficult due to non-specific clinical manifestations and unreliable serological tests for antibodies to Borrelia burgdorferi. In a national prospective study, 186 children with arthritis were examined in whom the attending physicians had considered the diagnosis of LA. Ultimately, LA was confirmed in 87 patients and these were compared with the remaining 99 children in whom arthritis was attributable to other causes. In comparison to patients with other causes of arthritis, patients with LA had a higher frequency of episodic arthritis and initial knee joint arthritis, reported tick bites more frequently, were older, had a lower frequency of initial arthralgias, and there were fewer large joints involved. A score was developed in a group of these patients and tested in a second group. It enabled patients with LA to be distinguished from those with other causes of arthritis: within a range from 12 to −7 points, a score of 2.5 or less excluded LA whereas 6 or more points were highly indicative of LA. If only those children with a score result between 2.5 and 6 had been tested for antibodies to B. burgdorferi, the number of tests would have been reduced by 63%. Conclusion Careful analysis of clinical presentation and use of a clinical score may help in distinguishing LA from other causes of arthritis and thus reduce unnecessary and expensive testing and uninterpretable test results. |
Databáze: | OpenAIRE |
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