Chronic Lyme arthritis. Clinical and immunogenetic differentiation from rheumatoid arthritis

Ann Intern Med. 1979 Jun;90(6):896-901. doi: 10.7326/0003-4819-90-6-896.

Abstract

Ten patients with Lyme arthritis have developed chronic involvement of one or both knees. Lyme arthritis was diagnosed by onset with erythema chronicum migrans (six patients); residence in Lyme, Connecticut (eight); seasonal onset in summer and early fall (nine); early periods of short recurrent attacks (nine); absence of rheumatoid factor (nine); and absence of symmetrical polyarthritis, morning stiffness, subcutaneous nodules, or antinuclear antibodies (in all). Five patients had synovectomies; pannus formation and underlying cartilage erosion were present in all. Seven of the 10 patients had the same B-cell alloantigen, DRw2 (frequency in normal control subjects, 22% [P less than 0.005]), but did not have an increased frequency of the alloantigens associated with rheumatoid arthritis. Chronic Lyme arthritis, the result of an apparent tick-transmitted infection, resembles rheumatoid arthritis pathologically but generally differs from it in both prearticular and immunogenetic characteristics.

Publication types

  • Comparative Study
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Arthritis / diagnosis*
  • Arthritis, Rheumatoid / diagnosis*
  • B-Lymphocytes / immunology
  • Child
  • Chronic Disease
  • Connecticut
  • Diagnosis, Differential
  • Erythema / diagnosis
  • Female
  • Humans
  • Isoantigens / isolation & purification
  • Knee Joint* / pathology
  • Male
  • Middle Aged
  • Rheumatoid Factor / isolation & purification
  • Seasons

Substances

  • Isoantigens
  • Rheumatoid Factor