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
2008
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 RESUMO A ocorrencia de manifestacoes clinicas e laboratoriais semelhantes as encontradas na doenca de Lyme e da coinfeccao com a babesiose ja foi demonstrada em trabalhos anteriores em adultos, porem nao existem estudos desta natureza em criancas. Objetivo: Caracterizar o perfil clinico-epidemiologico da sindrome de Lyme-Simile em criancas do Estado de Mato Grosso do Sul e avaliar a prevalencia dos anticorpos anti-Borrelia burgdorferi e anti-Babesia bovis no soro de pacientes que preencheram os criterios estabelecidos. Metodos: 100 pacientes entre 9 meses e 16 anos de idade foram submetidos a pesquisa dos anticorpos pela tecnica de ELISA e a soroprevalencia foi comparada com um grupo-controle. Resultados: Positividade para anticorpos anti-B. burgdorferi ocorreu em 27% dos pacientes com suspeita clinica, sendo 17% IgM e 12% IgG. As manifestacoes articulares ocorreram em 21 pacientes, as manifestacoes cutâneas em tres pacientes e as manifestacoes neurologicas em tres pacientes. A prevalencia de anticorpos contra B. burgdorferi nos pacientes do grupo-controle foi de 15% (p < 0,05). Os anticorpos anti-B. bovis estiveram presentes em 24% dos pacientes suspeitos e em 3% do grupo-controle (p < 0,05). Concomitância dos anticorpos ocorreu em 10 pacientes com suspeita clinica e em nenhum controle. Conclusao: Os resultados deste estudo evidenciam a etiologia de carater infeccioso e reacional das manifestacoes clinicas encontradas
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