Distribution of Borrelia burgdorferi specific antibody among patients with juvenile rheumatoid arthritis in Korea.

Lyme disease, a multi-systemic infection occurring worldwide, has yet to be reported in Korea, although the spirochete B. burgdorferi, known as the causative organism of the disease, has recently been isolated from the vector tick Ixodes persulcatus in the region. To contribute to revealing whether Lyme disease exists in Korea or not, B. burgdorferi specific antibodies (IgG, IgM, and/or IgA) were measured by three individual enzyme-linked immunosorbent assays (ELISA) utilizing different antigens in 38 patients with juvenile rheumatoid arthritis (JRA) which shares a number of clinical features with Lyme arthritis. The antibody prevalence rates in patients with JRA were various depending on the antigens (21% of IgG and IgM antibodies to purified organisms, 0% for IgG antibody to purified native flagella, and 5% for IgG, IgM, and IgA antibodies to recombinant p39) and were not different compared to 39 controls (21%, 0%, and 0% respectively). The antibody prevalence rates compared in various subgroups of patients with JRA according to types of JRA, length of illness, age, and sex were not different. Comparing the three different antigens, the greatest number of positive responders were yielded by purified organisms followed by p39 and purified flagellin, however the possibility of nonspecificity with purified organisms remained. The data indicate that serologic tests using ELISA fail to illustrate Lyme disease among 38 patients with JRA in Korea.