Université de Rennes 1 Caractéristiques clinicobiologiques et évolution après traitement des arthrites de Lyme dans la région Ouest de la France : étude multicentrique rétrospective de 52 patients Clinical, biological characteristics and evolutionafter treatment of Lyme arthritis in the West region of France: a multicentric retrospective study of 52 patients Arthrite de lymediagnosticévolutioninfiltration de corticoïdes Lyme arthritisdiagnosisevolutionglucocorticoid injection Lyme, Maladie de Diagnostic Injections Corticothérapie Rémission (médecine) 1 résumé en anglais Objective: To describe clinical and biological characteristics of patients affected by Lyme arthritis and undergoing evolution after antibiotic treatment in west region of France. Methods: Observational retrospective multicentric study in western France of Lyme arthritis defined by a clinical acute or chronic peripheral arthritis on native joint with a positive Borrelia burgdorferi serological testing confirmed by western blot, and/or the positivity of Borrelia PCR in the synovial fluid, and no other aetiology of arthritis. Results: 52 patients were included, with a mean age of 43 years old (± 19.4), including 29 men (55.8%) and 9 children (17.3%). The median delay between arthritis and Lyme disease diagnosis was 5 months (1.5-8). Lyme arthritis was a monoarthritis (82.7%), involving the knee (98.1%). The mean range of the CRP was 50.6 ± 53.4 mg/l. Median of synovial white blood cells count was 16000/mm3 (9230-40500). Lyme serological testing was always positive in IgG and more than 1/3 of them were positive in IgM. Borrelia PCR was positive in the synovial fluid or synovial biopsy in 16 cases (39%), with specie identification in 13 cases: B. sensu stricto (n=5), B. afzelii (n=3) and B. garinii (n=5). Every patient received antibiotics, mainly Doxycycline (84.6%) with a mean duration of 28 days. Out of the 47 followed patients, 35 (75%) were cured. A relapse was observed for 6 (17.1%) patients after a first line of antibiotics. GIAI associated with the first line of antibiotics was statistically associated with recovery (100% vs 66.7%, p=0.03), without more significant relapse (18.2% vs 16%, p=0.91). Conclusion: In our western France cohort, Lyme arthritis was presenting as a chronic monoarthritis of the knee. Synovial PCR testing only is not sensitive enough for diagnosis (39%), which requires a positive Lyme serological testing in the serum including an ELISA test confirmed by a positive Western Blot. All the 3 pathogenic species of Borreliella in Europe can be responsible of Lyme arthritis. Evolution after first line antibiotics showed 75% recovery. For the first time, we reported a higher rate of recovery when GIAI were associated with first-line antibiotic therapy without more relapse compared with antibiotics alone. Electronic Thesis or DissertationText en application/pdf1 : 931 Kohttps://ged.univ-rennes1.fr/nuxeo/site/esupversions/2f5a9e95-6848-48ab-a040-caf1ca0eb6aa Corre Clémence 1991-07-06 FR 243407289 clemence.corredml@gmail.com 2019REN1M194 http://www.theses.fr/2019REN1M194 2019-10-25 Rhumatologie Universite de Rennes 1thesis.degree.grantor_1 02778715X Doctorat (thèse d'exercice) non ouiCoiffierGuillaumeintervenant_1145169243 Universite Bretagne LoirepartenaireRecherche_1 191639044 ddc:610 CoiffierGuillaumeUniversite de Rennes 1Sciences et technologie, medecine, pharmacie, odontologie, droit, economie, gestion, philosophieUniversite Bretagne Loire Communaute des etablissements d enseignement superieur et de recherche (ComuE) ASCII PDF 953058 restriction 2019-10-25 2020-01-25 confidentialité 2019-10-25 2020-06-30 restriction 2019-10-25 2020-06-30