Abstract
BackgroundDespite Southern Norway is an endemic area for Lyme borreliosis there is a lack of data on Lyme arthritis (LA). In the literature controversies exist if acute LA can develop into chronic arthritis. Our objective was to identify and characterize patients with LA in Southern Norway and explore disease course after antibiotic treatment.MethodsPatients aged 20 years or older with arthritis and a positive serology for Borrelia burgdorferi infection (IgG and/or IgM) suspected of having LA were consecutively recruited either from general practitioners or from hospital departments.ResultsFrom January 2007 to December 2010 a total of 27 patients were assessed. Mean (range) age was 56 years (41–80) and mean symptom duration prior to inclusion was 11.2 weeks (1 day – 2 years). Definite LA was diagnosed in 16 patients, probable LA in 5 patients and 6 patients were concluded to have other arthritis disorders. Among the 21 LA patients 20 had mono-arthritis (knee 18, ankle 2) and 1 had polyarthritis.All LA patients responded favourable to antibiotic treatment and none of the patients developed chronic arthritis after long term follow up, not even in LA patients who had intraarticular glucocorticosteroid (GC) injection prior to antibiotic treatment.ConclusionsOur data shows that LA in Southern Norway is a benign disease which successfully can be treated with antibiotics even in patients treated with GC prior to antibiotics.
Highlights
Despite Southern Norway is an endemic area for Lyme borreliosis there is a lack of data on Lyme arthritis (LA)
Despite arthritis being a well-known manifestation of Borrelia burgdorferi sensu lato (Bb) infection, there is a lack of data on Lyme arthritis (LA) in Norway
Our clinical experience has been that LA is successfully treated with antibiotics without causing chronic arthritis even in patients treated with GC prior to antibiotic treatment
Summary
Despite Southern Norway is an endemic area for Lyme borreliosis there is a lack of data on Lyme arthritis (LA). Our objective was to identify and characterize patients with LA in Southern Norway and explore disease course after antibiotic treatment. The coastal part of Southern Norway is known as an endemic area for Lyme borreliosis [2]. In this area, Ixodes ricinus ticks are prevalent and Bb is found in about 25% of the ticks [3] and IgG antibodies against Bb is found in approximately 20% of the adult population [4]. Despite arthritis being a well-known manifestation of Bb infection, there is a lack of data on Lyme arthritis (LA) in Norway. In the literature there are controversies whether LA after antibiotic treatment can develop into chronic arthritis [9,10]. Our clinical experience has been that LA is successfully treated with antibiotics without causing chronic arthritis even in patients treated with GC prior to antibiotic treatment
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