Rational diagnosis and treatment in unclassified arthritis: how clinical data may guide requests for Lyme serology and antibiotic treatment
| Autor: | B A C Dijkmans, S van der Linden, I Blaauw, P Bouma |
|---|---|
| Rok vydání: | 1993 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Knee Joint Inflammatory arthritis Immunology Arthritis Lyme Arthritis Sensitivity and Specificity General Biochemistry Genetics and Molecular Biology Serology Lyme disease Rheumatology Borrelia burgdorferi Group Predictive Value of Tests Recurrence Internal medicine medicine Immunology and Allergy Humans Borrelia burgdorferi Aged Arthritis Infectious Lyme Disease biology business.industry Middle Aged medicine.disease biology.organism_classification bacterial infections and mycoses Antibodies Bacterial LYME Anti-Bacterial Agents Predictive value of tests Female business Research Article |
| Zdroj: | Annals of the rheumatic diseases. 52(3) |
| ISSN: | 0003-4967 |
| Popis: | To improve the appropriateness and efficiency of diagnostic serological tests and subsequent antibiotic treatment, clinical data from 102 patients with unclassified arthritis were analysed to investigate whether the presence of positive IgG antibodies to Borrelia burgdorferi could be predicted. The clinical data were blindly ranked from 1 to 4 (1, Lyme arthritis unlikely; 4, Lyme arthritis very likely). Antibodies to B burgdorferi were positive in nine of 102 patients (9%). Six of 15 (40%) patients with rank numbers 3 and 4 were positive for antibodies to B burgdorferi, in contrast with only three of 87 (3%) patients with rank numbers 1 and 2. The likelihood ratio of positive Lyme serology for patients ranked 3 and 4 was 12.0, for patients ranked 2 to 4, 4.5, and for patients with arthritis of the knee, 3.0. These likelihood ratios were associated with a post-test probability of 55, 30, and 20% respectively. The clinical history in patients with unclassified arthritis can largely predict the presence of antibodies to B burgdorferi. The absolute value of a likelihood ratio can be a contributing factor in deciding to request tests for antibodies to B burgdorferi in patients with unclassified arthritis. |
| Databáze: | OpenAIRE |
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