Revista Brasileira de Reumatologia (Apr 2008)
Pesquisa de anticorpos anti-Borrelia e anti-Babesia em soro de crianças com manifestações clínicas e epidemiologia compatíveis com a doença de Lyme-Simile no Estado de Mato Grosso do Sul Detection of anti-Borrelia and anti-Babesia antibodies in the serum of children with clinical manifestations and compatible epidemiology with Lyme-Like disease in the State of Mato Grosso do Sul
Abstract
A ocorrência de manifestações clínicas e laboratoriais semelhantes às encontradas na doença de Lyme e da coinfecção com a babesiose já foi demonstrada em trabalhos anteriores em adultos, porém não existem estudos desta natureza em crianças. OBJETIVO: Caracterizar o perfil clínico-epidemiológico da síndrome de Lyme-Símile em crianças do Estado de Mato Grosso do Sul e avaliar a prevalência dos anticorpos anti-Borrelia burgdorferi e anti-Babesia bovis no soro de pacientes que preencheram os critérios estabelecidos. MÉTODOS: 100 pacientes entre 9 meses e 16 anos de idade foram submetidos à pesquisa dos anticorpos pela técnica de ELISA e a soroprevalência foi comparada com um grupo-controle. RESULTADOS: Positividade para anticorpos anti-B. burgdorferi ocorreu em 27% dos pacientes com suspeita clínica, sendo 17% IgM e 12% IgG. As manifestações articulares ocorreram em 21 pacientes, as manifestações cutâneas em três pacientes e as manifestações neurológicas em três pacientes. A prevalência de anticorpos contra B. burgdorferi nos pacientes do grupo-controle foi de 15% (p The occurence of clinical and laboratory manifestations similar to the Lyme disease and the coinfection with babesiosis was already demonstraded in previous researches with adult patients. However, there are no studies in children. OBJECTIVE: To identify the clinical-epidemiological profile of the Lyme Simile Syndrome in children of the State of Mato Grosso do Sul and to evaluate the prevalence of antibodies against Borrelia burgdorferi and Babesia bovis in the serum of patients that had fulfilled the established criteria. METHODS: One hundred patients (age range: 9 months and 16 years-old) were screened for the presence of those antibodies, using ELISA, comparing to a control group. RESULTS: Antibodies against B. burgdoferi were found in 27% of the patients with a clinical picture. The articular manifestations occurred in 21 patients, cutaneous in 3 and neurological in 3. The prevalency in the control group was 15% (p < 0.05). The antibodies for Babesia bovis were present in 24% of suspect patients and in 3% of the control group (p < 0.05). Concomitance of the two antibodies occurred in 10 patients with clinical suspect and no one of control group. CONCLUSION: The results found in this study suggest the infective and reactive character of the clinical manifestations of the patients, which can characterize a Syndrome, which possibly occurs in the presence of multiple microorganisms that can be associated with tick-borne. It was found a higher frequency of antibodies against borrelia and babesia in patients in relation to the controls. Although small, this difference was statistically significant. This finding does not certify that the clinical features of patients is caused by species of borrelia or babesia, but raised the possibility of involvement of some infectious agent that could be related to these micro-organisms. The studies should continue in order to improve the delineation of this syndrome and to try the isolation of the etiologic agent in our State.
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