Diagnostic usefulness of routine Lyme serology in patients with early inflammatory arthritis in nonendemic areas.

OBJECTIVE

To evaluate the diagnostic usefulness of routine Lyme serology in patients who live in nonendemic areas and present with early inflammatory joint disease.

METHODS

All patients admitted to a rheumatology department of a nonendemic area of France for evaluation of joint disease with onset within the last year. The evaluation included a medical history, a thorough physical examination, an electrocardiogram, and an ELISA for antibodies to Borrelia burgdorferi.

RESULTS

We included 90 patients, 51 women and 39 men, with a mean age of 48.1 +/- 17.9 years. Mean duration of joint symptoms was 4.3 +/- 4.3 months, with a median of 3 months. A patient (1.1%) reported a tick bite and no patients had a history of erythema migrans. Lyme serology was negative in all 90 patients.

CONCLUSION

These results do not support routine Lyme serology in patients living in nonendemic areas and presenting with early inflammatory joint disease. However, Lyme serology remains appropriate in patients with features suggestive of Lyme disease. Given that Lyme disease is amenable to curative treatment, a larger study is in order to confirm our findings.