Clinical characteristics and serological profiles of Lyme disease in children: a 15-year retrospective cohort study in SwitzerlandResearch in context

Summary: Background: Lyme disease (LD) is caused by Borrelia burgdorferi and is the most common tickborne disease in the northern hemisphere. Although classical characteristics of LD are well-known, the diagnosis and treatment are often delayed. Laboratory diagnosis by serological testing is recomm...

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Main Authors: Beat M. Greiter, Semjon Sidorov, Ester Osuna, Michelle Seiler, Christa Relly, Annette Hackenberg, Isabelle Luchsinger, Elvira Cannizzaro, Roland Martin, Martina Marchesi, Stefanie von Felten, Adrian Egli, Christoph Berger, Patrick M. Meyer Sauteur
Format: Article
Language:English
Published: Elsevier 2025-01-01
Series:The Lancet Regional Health. Europe
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Online Access:http://www.sciencedirect.com/science/article/pii/S2666776224003120
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author Beat M. Greiter
Semjon Sidorov
Ester Osuna
Michelle Seiler
Christa Relly
Annette Hackenberg
Isabelle Luchsinger
Elvira Cannizzaro
Roland Martin
Martina Marchesi
Stefanie von Felten
Adrian Egli
Christoph Berger
Patrick M. Meyer Sauteur
author_facet Beat M. Greiter
Semjon Sidorov
Ester Osuna
Michelle Seiler
Christa Relly
Annette Hackenberg
Isabelle Luchsinger
Elvira Cannizzaro
Roland Martin
Martina Marchesi
Stefanie von Felten
Adrian Egli
Christoph Berger
Patrick M. Meyer Sauteur
author_sort Beat M. Greiter
collection DOAJ
description Summary: Background: Lyme disease (LD) is caused by Borrelia burgdorferi and is the most common tickborne disease in the northern hemisphere. Although classical characteristics of LD are well-known, the diagnosis and treatment are often delayed. Laboratory diagnosis by serological testing is recommended for most LD manifestations. The objective of this study was to describe clinical characteristics and associated serological profiles in children with LD. Methods: This retrospective cohort study included children aged 0–18 years, diagnosed with LD according to current guidelines at University Children's Hospital Zurich between January 1, 2006 and December 31, 2020. Two-tier serological testing with the recomWell enzyme-linked immunosorbent assay and recomLine Western blot (MIKROGEN Diagnostik, MIKROGEN GmbH, Neuried, Germany) was performed at the Institute of Medical Microbiology, University of Zurich. Findings: In total, 469 children diagnosed with LD were included (median age, 7.9 years); 190 patients (40.5%) with Lyme neuroborreliosis (LNB), 171 (36.5%) patients with skin manifestations (erythema migrans, n = 121; multiple erythema migrans, n = 11; borrelial lymphocytoma, n = 37; and acrodermatitis chronica atrophicans, n = 2), and 108 (23.0%) patients with Lyme arthritis. We observed seasonal variations for patients with skin manifestations and LNB, with high prevalence in May–October, but not for patients with Lyme arthritis. Significant differences between LD manifestation groups were found for age, inflammatory parameters, and specificity and concentration of B. burgdorferi-specific serum antibody responses. We observed distinct patterns of pronounced serum antibody responses against B. burgdorferi antigens in LNB (IgM against VlsE, p41, and OspC) and Lyme arthritis (IgG against p100, VlsE, p58, p41, p39, and p18). Interpretation: Our study is one of the largest and most detailed for children with LD. We present unique findings regarding the differences in clinical characteristics and immune responses between various manifestations of LD in children. Funding: No specific funding to disclose for this study.
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spelling doaj-art-e2f324252f0f4d2c972bf849fa4d9e1d2025-08-20T02:49:59ZengElsevierThe Lancet Regional Health. Europe2666-77622025-01-014810114310.1016/j.lanepe.2024.101143Clinical characteristics and serological profiles of Lyme disease in children: a 15-year retrospective cohort study in SwitzerlandResearch in contextBeat M. Greiter0Semjon Sidorov1Ester Osuna2Michelle Seiler3Christa Relly4Annette Hackenberg5Isabelle Luchsinger6Elvira Cannizzaro7Roland Martin8Martina Marchesi9Stefanie von Felten10Adrian Egli11Christoph Berger12Patrick M. Meyer Sauteur13Division of Infectious Diseases and Hospital Epidemiology, Children's Research Center, University Children's Hospital Zurich, University of Zurich, Zurich, SwitzerlandDivision of Infectious Diseases and Hospital Epidemiology, Children's Research Center, University Children's Hospital Zurich, University of Zurich, Zurich, SwitzerlandDivision of Infectious Diseases and Hospital Epidemiology, Children's Research Center, University Children's Hospital Zurich, University of Zurich, Zurich, SwitzerlandEmergency Department, University Children's Hospital Zurich, Zurich, SwitzerlandDivision of Infectious Diseases and Hospital Epidemiology, Children's Research Center, University Children's Hospital Zurich, University of Zurich, Zurich, SwitzerlandDepartment of Pediatric Neurology, University Children's Hospital Zurich, Zurich, SwitzerlandDepartment of Dermatology, Pediatric Skin Center, University Children's Hospital Zurich, Zurich, SwitzerlandDepartment of Rheumatology, University Children's Hospital Zurich, Zurich, SwitzerlandInstitute of Experimental Immunology, University of Zurich, Zurich, SwitzerlandInstitute of Medical Microbiology, University of Zurich, Zurich, Switzerland; Medica-Medical Laboratories, Zurich, SwitzerlandDepartment of Biostatistics at Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich, Zurich, SwitzerlandInstitute of Medical Microbiology, University of Zurich, Zurich, SwitzerlandDivision of Infectious Diseases and Hospital Epidemiology, Children's Research Center, University Children's Hospital Zurich, University of Zurich, Zurich, SwitzerlandDivision of Infectious Diseases and Hospital Epidemiology, Children's Research Center, University Children's Hospital Zurich, University of Zurich, Zurich, Switzerland; Corresponding author. Division of Infectious Diseases and Hospital Epidemiology, Children's Research Center, University Children's Hospital Zurich, University of Zurich, Lenggstrasse 30, Zurich, CH-8008, Switzerland.Summary: Background: Lyme disease (LD) is caused by Borrelia burgdorferi and is the most common tickborne disease in the northern hemisphere. Although classical characteristics of LD are well-known, the diagnosis and treatment are often delayed. Laboratory diagnosis by serological testing is recommended for most LD manifestations. The objective of this study was to describe clinical characteristics and associated serological profiles in children with LD. Methods: This retrospective cohort study included children aged 0–18 years, diagnosed with LD according to current guidelines at University Children's Hospital Zurich between January 1, 2006 and December 31, 2020. Two-tier serological testing with the recomWell enzyme-linked immunosorbent assay and recomLine Western blot (MIKROGEN Diagnostik, MIKROGEN GmbH, Neuried, Germany) was performed at the Institute of Medical Microbiology, University of Zurich. Findings: In total, 469 children diagnosed with LD were included (median age, 7.9 years); 190 patients (40.5%) with Lyme neuroborreliosis (LNB), 171 (36.5%) patients with skin manifestations (erythema migrans, n = 121; multiple erythema migrans, n = 11; borrelial lymphocytoma, n = 37; and acrodermatitis chronica atrophicans, n = 2), and 108 (23.0%) patients with Lyme arthritis. We observed seasonal variations for patients with skin manifestations and LNB, with high prevalence in May–October, but not for patients with Lyme arthritis. Significant differences between LD manifestation groups were found for age, inflammatory parameters, and specificity and concentration of B. burgdorferi-specific serum antibody responses. We observed distinct patterns of pronounced serum antibody responses against B. burgdorferi antigens in LNB (IgM against VlsE, p41, and OspC) and Lyme arthritis (IgG against p100, VlsE, p58, p41, p39, and p18). Interpretation: Our study is one of the largest and most detailed for children with LD. We present unique findings regarding the differences in clinical characteristics and immune responses between various manifestations of LD in children. Funding: No specific funding to disclose for this study.http://www.sciencedirect.com/science/article/pii/S2666776224003120Borrelia burgdorferiErythema migransFacial nerve palsyMeningitisNeuroborreliosisLyme arthritis
spellingShingle Beat M. Greiter
Semjon Sidorov
Ester Osuna
Michelle Seiler
Christa Relly
Annette Hackenberg
Isabelle Luchsinger
Elvira Cannizzaro
Roland Martin
Martina Marchesi
Stefanie von Felten
Adrian Egli
Christoph Berger
Patrick M. Meyer Sauteur
Clinical characteristics and serological profiles of Lyme disease in children: a 15-year retrospective cohort study in SwitzerlandResearch in context
The Lancet Regional Health. Europe
Borrelia burgdorferi
Erythema migrans
Facial nerve palsy
Meningitis
Neuroborreliosis
Lyme arthritis
title Clinical characteristics and serological profiles of Lyme disease in children: a 15-year retrospective cohort study in SwitzerlandResearch in context
title_full Clinical characteristics and serological profiles of Lyme disease in children: a 15-year retrospective cohort study in SwitzerlandResearch in context
title_fullStr Clinical characteristics and serological profiles of Lyme disease in children: a 15-year retrospective cohort study in SwitzerlandResearch in context
title_full_unstemmed Clinical characteristics and serological profiles of Lyme disease in children: a 15-year retrospective cohort study in SwitzerlandResearch in context
title_short Clinical characteristics and serological profiles of Lyme disease in children: a 15-year retrospective cohort study in SwitzerlandResearch in context
title_sort clinical characteristics and serological profiles of lyme disease in children a 15 year retrospective cohort study in switzerlandresearch in context
topic Borrelia burgdorferi
Erythema migrans
Facial nerve palsy
Meningitis
Neuroborreliosis
Lyme arthritis
url http://www.sciencedirect.com/science/article/pii/S2666776224003120
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