LABORATORY CHARACTERISTICS OF ERYTHEMOUS AND NON-ERYTHEMOUS FORMS OF LYME DISEASE IN CHILDREN
DOI:
https://doi.org/10.11603/24116-4944.2023.2.14259Keywords:
Lyme disease, children, immunoblot, Borrelia, erythema migrans, Lyme carditis, Lyme arthritis, cytokinesAbstract
The aim of the study – to analyze the clinical and laboratory features of erythematous and non-erythematous forms of Lyme disease in children of the Lviv region.
Materials and Methods. A prospective study involving 102 children aged from 1 year 4 months (16 months) to 17 years with confirmed diagnoses of early localized, early disseminated, and late stages of Lyme disease was conducted.
Results and Discussion. The mean age of patients was 8.0 years in group 1, 5.5 years in group 2, and 8.0 years in group 3. The average values of peripheral blood indicators were within the normal range for patients in all clinical groups. We found that C-reactive protein was highest in patients in group 3, reaching 5.0 mg/L. Interleukin-6 in group 3 was significantly higher compared to groups 1 and 2. The median level of creatine kinase-MB (CK-MB) in patients in group 2 was 28.0 U/L, which was significantly higher than in children in clinical groups 1 and 3. The highest median level of anti-streptolysin O (ASLO) was registered in patients in group 3, where this indicator was 178.0 IU/mL. In a quarter of children in groups 1 and 2, IgM levels >200 U/mL were detected, while in group 3, none of the patients showed such indicators. In all clinical groups, the highest levels were observed for detected IgM to p41 and OspC Ba, as well as IgG to p41, VlsE Bb, and VlsE Ba.
Conclusions. Children with LB are most often diagnosed with erythema migrans (62.75 %). Markers of the inflammatory process were found to be significantly higher in children with non-erythematous form of Lyme disease. IgM>200 units/ml were detected only in patients with erythematous forms of Lyme disease. Mean IgG levels in individuals with non-erythematous forms of Lyme borreliosis were eight times higher than in children with erythema migrans. IgG to VlsE Bа was most often detected in patients with erythematous forms of Lyme disease.
References
Andreychyn, M. A., Korda M. M., Shkilna M. I., Ivakhiv O. L. (2021). Lyme-borreliosis [Lyme disease]. Ternopil: TNMU, Ukrmedknyha [in Ukrainian].
Sorokman, T. V., Moldovan, P. M., & Sorokman, T. V. (2018). Khvoroba Laima u dytiachomu vitsi: pohliad na problemu ta klinichnyi vypadok [ Lyme disease in childhood: an overview of the problem and a clinical case] [in Ukrainian].
Lytvyn, H. O., & Basa, N. R. (2021). Khvoroba laima u ditei na suchasnomu etapi [Lyme disease in children at the current stage]. Infektsiini khvoroby - Infectious diseases, (2), 73-84 [in Ukrainian].
Zinchuk, O. M. (2008). Bezerytemni formy laim-boreliozu: vazhlyvist svoiechasnoi diahnostyky [Non-erythematous forms of Lyme borreliosis: the importance of timely diagnosis] . Naukovyi visnyk Uzhhorodskoho universytetu. Ser.: Medytsyna - Scientific Bulletin of Uzhhorod University, "Medicine" series., (34), 60-62, [in Ukrainian].
Volokha, A. P. (2014). Khvoroba Laima (klishchovyi borelioz) u ditei [Lyme disease (tick-borne borreliosis) in children]. Infektsiini khvoroby - Infectious diseases, (1), [in Ukrainian]..
Kozlovska A. (2020). Laim-borelioz: suchasnyi alhorytm diahnostyky, likuvannia ta profilaktyky [Lyme-borreliosis: a modern algorithm of diagnosis, treatment and prevention] . Ukrainskyi medychnyi chasopys - Ukrainian Medical Journal, [elektronnyi resurs] [in Ukrainian].
Vig, D. K., & Wolgemuth, C. W. (2014). Spatiotemporal evolution of erythema migrans, the hallmark rash of Lyme disease. Biophysical journal, 106(3), 763–768. https://doi.org/10.1016/j.bpj.2013.12.017 DOI: https://doi.org/10.1016/j.bpj.2013.12.017
Wasiluk, A., Zalewska-Szajda, B., Waszkiewicz, N., Kępka, A., Szajda, D., Wojewódzka-Żeleźniakowicz, M., Ładny, Pancewicz, S., Zwierz, Z.W., & Zwierz, K. (2011). Lyme disease: etiology, pathogenesis, clinical courses, diagnostics and treatment. Progress in Health Sciences, 1, 179-186.
Hein, Sander, Giryes, Reinhardt, Hoegel, & Schneider. (2019). Cytokine Expression Patterns and Single Nucleotide Polymorphisms (SNPs) in Patients with Chronic Borreliosis. Antibiotics, 8(3), 107. MDPI AG. Retrieved from http://dx.doi.org/10.3390/antibiotics8030107 DOI: https://doi.org/10.3390/antibiotics8030107
Yehudina, Y., & Trypilka, S. (2021). Lyme Borreliosis as a Trigger for Autoimmune Disease. Cureus, 13(10) [in Ukrainian]. DOI: https://doi.org/10.7759/cureus.18648
Cross, A., Bouboulis, D., Shimasaki, C., & Jones, C. R. (2021). Case Report: PANDAS and Persistent Lyme Disease With Neuropsychiatric Symptoms: Treatment, Resolution, and Recovery. Frontiers in psychiatry, 12, 505941. https://doi.org/10.3389/fpsyt.2021.505941 DOI: https://doi.org/10.3389/fpsyt.2021.505941
Ogden, N. H., Gasmi, S., Koffi, J. K., Barton, M., Lindsay, L. R., & Langley, J. M. (2020). Lyme disease in children: Data from the Canadian Paediatric Surveillance Program. Ticks and tick-borne diseases, 11(2), 101347. https://doi.org/10.1016/j.ttbdis.2019.101347 DOI: https://doi.org/10.1016/j.ttbdis.2019.101347
Uhde, M., Ajamian, M., Li, X., Wormser, G. P., Marques, A., & Alaedini, A. (2016). Expression of C-Reactive Protein and Serum Amyloid A in Early to Late Manifestations of Lyme Disease. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 63(11), 1399–1404. https://doi.org/10.1093/cid/ciw599 DOI: https://doi.org/10.1093/cid/ciw599
Nykytyuk, S. O., Klymnyuk, S. I., Klishch, I. M., & Levenets, S. S. (2021). Evaluation of immunoblot results for determination of antibodies to lyme disease pathogens in children of Ternopil region. Int J Med Medical Res, 7, 76-82 [in Ukrainian]. DOI: https://doi.org/10.11603/ijmmr.2413-6077.2021.2.12657
Shostakovych-Koretska, L. R., Budayeva, І. V., Cherginets, А. V., Mavrutenkov, V. V., & Marchenko, N. Y. (2014). Laim-borelioz: pytannia diahnostyky i terapii [Lyme-borreliosis: issues of diagnosis and therapy].ACTUAL INFECTOLOGY – ACTUAL INFECTOLOGY , (2.03), 34-38 [in Ukrainian]. DOI: https://doi.org/10.22141/2312-413x.2.03.2014.82346
Kulias, S. M. (2013). Suchasnyi pohliad na osoblyvosti spetsyfichnoi diahnostyky, likuvannia ta profilaktyky laim-boreliozu [A modern look at the features of specific diagnosis, treatment and prevention of Lyme borreliosis]. Biomedical and biosocial anthropology, (20), 245-251 [in Ukrainian].
Engstrom, S. M., Shoop, E., & Johnson, R. C. (1995). Immunoblot interpretation criteria for serodiagnosis of early Lyme disease. Journal of clinical microbiology, 33(2), 419–427. https://doi.org/10.1128/jcm.33.2.419-427.1995 DOI: https://doi.org/10.1128/jcm.33.2.419-427.1995
Caine, J. A., Lin, Y. P., Kessler, J. R., Sato, H., Leong, J. M., & Coburn, J. (2017). Borrelia burgdorferi outer surface protein C (OspC) binds complement component C4b and confers bloodstream survival. Cellular microbiology, 19(12), 10.1111/cmi.12786. https://doi.org/10.1111/cmi.12786 DOI: https://doi.org/10.1111/cmi.12786
Ma, B., Christen, B., Leung, D., & Vigo-Pelfrey, C. (1992). Serodiagnosis of Lyme borreliosis by western immunoblot: reactivity of various significant antibodies against Borrelia burgdorferi. Journal of clinical microbiology, 30(2), 370–376. https://doi.org/10.1128/jcm.30.2.370-376.1992 DOI: https://doi.org/10.1128/jcm.30.2.370-376.1992
Aguero-Rosenfeld, M. E., Nowakowski, J., McKenna, D. F., Carbonaro, C. A., & Wormser, G. P. (1993). Serodiagnosis in early Lyme disease. Journal of clinical microbiology, 31(12), 3090–3095. https://doi.org/10.1128/jcm.31.12.3090-3095.1993 DOI: https://doi.org/10.1128/jcm.31.12.3090-3095.1993
Bankhead T. (2016). Role of the VlsE Lipoprotein in Immune Avoidance by the Lyme Disease Spirochete Borrelia burgdorferi. Forum on immunopathological diseases and therapeutics, 7(3-4), 191–204. https://doi.org/10.1615/ForumImmunDisTher.2017019625 DOI: https://doi.org/10.1615/ForumImmunDisTher.2017019625
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Actual Problems of Pediatrics, Obstetrics and Gynecology
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish in this journal agree to the following terms:
1. The authors reserve the right to authorship of the work and pass the journal right of first publication of this work is licensed under a Creative Commons Attribution License, which allows others to freely distribute the work published with reference to the authors of the original work and the first publication of this magazine.
2. Authors are entitled to enter into a separate agreement on additional non-exclusive distribution of work in the form in which it was published in the magazine (eg work place in the electronic repository institution or publish monographs in part), provided that the reference to the first publication of this magazine.
3. Policy magazine allows and encourages authors placement on the Internet (eg, in storage facilities or on personal websites) manuscript of how to submit the manuscript to the editor and during his editorial processing, since it contributes to productive scientific discussion and positive impact on the efficiency and dynamics of citing published work (see. The Effect of Open Access).
