Articular involvement in European patients with Lyme disease. A report of 32 Italian patients

Lyme disease (LD) is a well recognized multisystem disorder, caused by the spirochaete Borrelia burgdorferi. It involves the skin, nervous system and heart. Arthritis is described in 50-60% of American patients but seems to be less common in Europe. We studied the pattern of articular involvement in a group of 67 Italian patients with LD. Thirty-two (48%) of 67 had rheumatological manifestations. The prevalence of arthritis in our patients was 16/67 (24%), the remaining 16 experiencing only arthralgia. The pattern of articular involvement did not differ from the literature and was most often mono- or oligoarthritis with polyarticular arthralgia. We noted an early onset of articular symptoms (range 1-3 months). Incidence of early and late manifestations of LD were in keeping with previous reports. In addition, interpreting serological tests for antibodies against B. burgdorferi and the real prevalence of arthritis in LD is complicated by the possible existence of seronegative LD and by the effect of early antibiotic treatment.