OBJECTIVE: To describe clinical and serologic features of Lyme borreliosis, particularly the joint abnormalities, in Russian patients. METHODS: Physicians were invited to refer patients with past or present erythema migrans to the Rheumatology Institute in Moscow; field studies were done of residents in an area endemic for Lyme borreliosis, and a serosurvey was conducted of patients with nonspecific neurologic, cardiac, or joint symptoms. Serologic testing was done by ELISA and Western blotting using a strain of Borrelia afzelii, a member of the B. burgdorferi sensu lato complex, recovered from ticks from the field study site. RESULTS: Of 86 patients with erythema migrans, neurologic abnormalities developed in 26 (30%), cardiac involvement in 5 (6%), arthritis or arthralgia in 35 (41%), and acrodermatitis in 2 (2%). Joint involvement was usually characterized by one or a few brief episodes of joint swelling or pain in one large joint at a time. However, 69 of the 86 patients (80%) received antibiotic therapy early in the infection. The majority of patients with active infection had elevated levels of IgM or IgG antibody to B. afzelii by ELISA, and those with late infection often had IgG reactivity with > or = 5 spirochetal proteins, particularly the 37, 39, 41, 60, and 93 kDa antigens. In a serosurvey of 75 patients with facial palsy, atrioventricular block, or arthritis or arthralgia of uncertain cause, 6 had IgG reactivity with > or = 5 spirochetal proteins. CONCLUSION: Lyme borreliosis in Russia is similar to that in other parts of Europe. Brief episodes of arthritis or arthralgia were a common feature of the illness.

Adolescent↗

PubMed1995

[The clinical and serological manifestations of Lyme disease in Russia].

Out of 86 Lyme's disease patients with a history of migrating erythema nervous system, cardiovascular and articular involvement was observed in 27, 6 and 43% of cases. Acrodermatitis was diagnosed in 2% of patients. Affection of locomotor system manifested with acute arthritis episodes or pains in major joints. 11 patients of 12 examined at arthritis onset showed elevated titer of anti-Borrelia IgG antibodies. Serologically, of 80 patients with arthritis or arthralgia without prior migrating erythema 6 demonstrated antibodies to 5 and more Borrelia polypeptides.

Adolescent↗

PubMed1995

[The clinical instrumental characteristics of the locomotor involvement in patients who have had Lyme disease].

Locomotor system has been studied in 24 patients with a history of Lyme's disease. All of them had arthralgia, 11 had relapsing arthritis, chronic arthritis occurred in 6 examinees. Arthritis presented as recurrent asymmetric mono-oligoarthritis affecting primarily joints of the lower limbs. Periarticular disorders were detected in 12 patients. Serologically, 18 of 24 patients had elevated titers of antibodies to Borrelia burgdorferi in indirect immunofluorescence test. Scintigraphy revealed polyarticular lesions in many cases, ultrasound investigation of the joints confirmed inflammatory nature of the pathological changes. It is inferred that combined methods of examination in diagnosis of Lyme's arthritis (titers to antibodies to Borrelia burgdorferi, ultrasound investigations, scintigraphy of the joints) provide most complete information.

Adolescent↗

PubMed1995

[The humoral immunological response of patients with Lyme disease].

Indirect immunofluorescence (II), enzyme-labelled antibodies (ELA), immune blotting (IB) were used for serological evaluation of 74 patients with Lyme disease living in the North-West and Central regions of Russia. Both acute and chronic borreliosis can be seropositive or seronegative. As shown by II and ELA, these patients had a moderate humoral response, high titers of the specific antibodies being a rare finding. The range of anti-Borrelia antibodies (ABA) identified by IB is limited and, as a rule, includes antibodies to no more than 5 proteins of Borrelia burgdorferi. The highest ABA levels were associated with locomotor lesions and were significantly greater of the above levels in patients with migrating erythema. Informative value of II and ELA in Lyme's disease diagnosis according to this study is equal because ELA is more sensitive, while II is more specific. They are both of little help in atypical borreliosis presentation. Most available of other adequate serological tests is IB.

Adolescent↗

PubMed1993

[Antibodies to pathogens of Lyme's disease in patients with myocarditis and dilated cardiomyopathy].

The paper presents the information on the involvement of the cardiovascular system in the patients with Lyme's disease as well as the results of serological investigation in patients with myocarditis and dilatation cardiomyopathy for the presence of antibodies to the causative agent of Lyme's disease with the aid of enzyme immunoassay. Out of 71 sera 3 specimens had the values of optical density higher than the upper normal limits. Based on the investigation conducted and the analysis of the clinical picture, the authors suspected a Borrelia origin of these cardiac involvements. However, to verify the diagnosis morphological examination of endomyocardiac biopsy specimens was found to be mandatory.

Adolescent↗

PubMed1993

[Lyme arthritis].

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Anti-Bacterial Agents↗

PubMed1992

[The results of a clinico-serological examination of 60 patients with Lyme disease].

Clinical and serological examinations were carried out in 60 patients with Lyme disease. The diagnosis was established on the basis of the disease marker--tick-borne migrating erythema and serological data obtained with the use of indirect immunofluorescence and Western blot. The spectrum of clinical manifestations and the rate of different clinical syndromes are described and compared with the data by this country and foreign authors. It is shown that Borrelia infection is capable of imitating rheumatic diseases.

Adolescent↗

PubMed1990

[The clinical aspects of Lyme disease].

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Anti-Bacterial Agents↗

PubMedDate not supplied

[A description of a case of Lyme disease in eastern Siberia].

A typical case of Lyme's borreliosis with classical stage course has been described in a 56-year-old male residing in Severobaĭkalsk. This case confirms the possibility of infestation with Lyme's disease in the regions where Ixodes ticks are widespread, as they are vectors of both tick-borne encephalitis virus and Lyme's borreliosis.

Humans↗

PubMedDate not supplied

[The experience of a serological examination of the rural population in a territory endemic for Lyme borreliosis].

Serological surveys have been performed in two communities (Kirovsk District, Leningrad Province) endemic for Lyme's borreliosis. 736 individuals (51% of the population) have been examined. Standard capillary blood samples (drops from the finger on a filter paper) have been investigated by indirect immunofluorescence. Blood sera of residents from nonendemic territories and patients with various rheumatic diseases served as a control. Serum dilution 1:80 was considered as a reliable screening titre. In general, the seroprevalence was shown to account for 9%.

Antibodies, Bacterial↗

PubMedDate not supplied

[A clinico-serological study of Lyme disease in the northwestern USSR].

To reveal clinical signs and symptoms of Lyme's disease in the population of the endemic area, clinical and serological examinations of 416 persons have been performed. Preliminary screening, using indirect immunofluorescence, has revealed in 230 persons (group I) antibodies to the agent of the disease at a titre of greater than or equal to 1:20. Group II consisted of 186 patients who had not been serologically examined. Lyme's disease diagnosed in most cases by erythema annulare was found in 8 patients from group I and 12 patients from group II, all in all in 20 patients (4.8%) of all the patients examined. No typical late signs and symptoms of Lyme's disease have been observed. High antibody titres (greater than or equal to 1:80) were found in 24% of patients in group I and in 4.1% of patients in group II. Different clinical and immunological courses of borreliosis in the endemic area are discussed.

Antibodies, Bacterial↗