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Lyme-Arthritis

Häufigste späte Manifestation der Lyme-Borreliose

  • Infektionen durch Zecken
  • Published:
Monatsschrift Kinderheilkunde Aims and scope Submit manuscript

An Erratum to this article was published on 01 January 2004

Zusammenfassung

Die in Europa und Nordamerika vorkommende Lyme-Borreliose ist eine komplexe Multisystemerkrankung, die auch noch Monate oder Jahre nach der Infektion zur Arthritis führen kann. Der Zusammenhang mit einem vorangegangenen Zeckenstich, ja überhaupt die infektiöse Ursache der Erkrankung sind nicht sofort evident. Typisch ist der Befall des Kniegelenks in Form einer episodischen Arthritis, z. T. mit massivem Erguss, der den Patienten erstaunlich wenig beeinträchtigt. Diagnostik und antibiotische Therapie können schwierig sein und sind z. T. noch umstritten. Bei 10–20% der Patienten erweist sich die Arthritis als antibiotikarefraktär und wird dann antirheumatisch behandelt. Aus pathogenetischer Sicht ist die Lyme-Arthritis ein menschliches Modell für die Auslösung einer chronischen Synovialitis durch einen Infektionserreger. Zu den diskutierten Mechanismen gehören Erregerpersistenz, immunpathologische Reaktionen und Autoimmunphänomene.

Abstract

Lyme borreliosis occurring in Europe and North America is a complex multisystem disease including arthritis which may appear months or even years after the infection. The relation to a preceding tick bite and even the infectious character of the disease may not be apparent. The typical case may present with episodic arthritis involving the knee joint, and some patients have a large effusion with astonishingly few symptoms. Diagnosis and antibiotic treatment may be difficult and are in part under debate. In 10–20% of patients, arthritis is refractory to antibiotic therapy and then treated by antirheumatic drugs. From a pathogenetic perspective, Lyme arthritis is a human model for the initiation of chronic synovitis by an infectious agent. Proposed mechanisms include persistence of the infectious agent, immunopathologic reactions, and autoimmunity.

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Authors and Affiliations

  1. Prof.-Hess-Kinderklinik, Zentralkrankenhaus Bremen

    H.-I. Huppertz

  2. Prof.-Hess-Kinderklinik, Zentralkrankenhaus Bremen, Sankt-Jürgen-Straße, 28205 , Bremen

    H.-I. Huppertz

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Correspondence to H.-I. Huppertz.

Additional information

Ein Erratum zu diesem Beitrag ist unter http://dx.doi.org/10.1007/s00112-003-0879-7 zu finden.

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Huppertz, HI. Lyme-Arthritis. Monatsschr Kinderheilkd 151, 1156–1162 (2003). https://doi.org/10.1007/s00112-003-0820-0

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  • DOI: https://doi.org/10.1007/s00112-003-0820-0

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