Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Jan 11;2(1):e000120.
doi: 10.1136/rmdopen-2015-000120. eCollection 2016.

Diagnostic impact of routine Lyme serology in recent-onset arthritis: results from the ESPOIR cohort

Dewi Guellec  1 , Valérie Narbonne  2 , Divi Cornec  3 , Thierry Marhadour  3 , Sophie Varache  3 , Maxime Dougados  4 , Jean Pierre Daurès  5 , Sandrine Jousse-Joulin  3 , Valérie Devauchelle-Pensec  3 , Alain Saraux  3
Affiliations

Diagnostic impact of routine Lyme serology in recent-onset arthritis: results from the ESPOIR cohort

Dewi Guellec et al. RMD Open. .

Abstract

Objectives: Lyme disease may be considered by rheumatologists in patients with recent-onset arthritis, even in the absence of suggestive symptoms. The aim of this study was to determine the diagnostic impact of routine Lyme serology in a French cohort of patients with recent-onset arthritis affecting at least 2 joints.

Methods: We performed an ancillary study of a French prospective multicentre cohort established to monitor clinical, biological and radiographic data in patients with inflammatory arthritis in at least 2 joints, lasting for 6 weeks to 6 months. Borrelia IgM and IgG antibodies were sought routinely at baseline, using ELISA tests, independently from the physician's strategy for detecting a spirochetal infection. We recorded the proportion of patients with a final diagnosis of Lyme arthritis and evaluated the diagnostic performance of Lyme serology in this particular context. The clinical and biological characteristics of patients according to the Lyme serology results were analysed.

Results: Of 810 patients, 657 (81.1%) were negative for IgM and IgG antibodies, 91 (11.2%) had only IgM antibodies, 49 (6%) had only IgG antibodies, and 13 (1.6%) had IgG and IgM antibodies. Thus, 7.6% had IgG positivity, consistent with exposure to Borrelia infection. IgG positivity was significantly more prevalent in the North and North-East regions of France (χ(2)=14.6, p<0.001). No patients received a definite diagnosis of Lyme arthritis.

Conclusions: This study does not support routine Lyme serological testing in patients with recent-onset inflammatory arthritis affecting more than 1 joint.

Keywords: Arthritis; Epidemiology; Infections.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Prevalence of IgG antibodies according to the region of inclusion (map produced by DrawMeAGraph.com). The white areas correspond to regions with no data. The green areas correspond to regions with available data, the colour intensity being proportional to the prevalence of IgG antibodies.
See this image and copyright information in PMC

References

    1. Shapiro ED. Lyme disease. N Engl J Med 2014;371:684 10.1056/NEJMc1407264 - DOI - PMC - PubMed
    1. Rizzoli A, Hauffe H, Carpi G et al. . Lyme borreliosis in Europe. Euro Surveill 2011;16:pii19906. - PubMed
    1. Mariet AS, Retel O, Avocat H et al. . Estimated incidence of erythema migrans in five regions of France and ecological correlations with environmental characteristics. Vector Borne Zoonotic Dis 2013;13:666–73. 10.1089/vbz.2012.1199 - DOI - PubMed
    1. Steere AC, Sikand VK. The presenting manifestations of Lyme disease and the outcomes of treatment. N Engl J Med 2003;348:2472–4. 10.1056/NEJM200306123482423 - DOI - PubMed
    1. Stinco G, Ruscio M, Bergamo S et al. . Clinical features of 705 Borrelia burgdorferi seropositive patients in an endemic area of northern Italy. Scientific World J 2014:414505 10.1155/2014/414505 - DOI - PMC - PubMed

LinkOut - more resources