{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T20:58:30Z","timestamp":1791406710672,"version":"4.3.3"},"reference-count":50,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2016,12,28]],"date-time":"2016-12-28T00:00:00Z","timestamp":1482883200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arthritis &amp; Rheumatology"],"published-print":{"date-parts":[[2017,1]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To describe systemic autoimmune joint diseases that develop following Lyme disease, and to compare their clinical features with those of Lyme arthritis (LA).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We reviewed records of all adult patients referred to our LA clinic over a 13\u2010year period, in whom we had diagnosed a systemic autoimmune joint disease following Lyme disease. For comparison, records of patients enrolled in our LA cohort over the most recent 2\u2010year period were analyzed. Levels of IgG antibodies to <jats:italic>Borrelia burgdorferi<\/jats:italic> and to 3 Lyme disease\u2013associated autoantigens were measured.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We identified 30 patients who had developed a new\u2010onset systemic autoimmune joint disorder a median of 4 months after Lyme disease (usually manifested by erythema migrans [EM]). Fifteen had rheumatoid arthritis (RA), 13 had psoriatic arthritis (PsA), and 2 had peripheral spondyloarthritis (SpA). The 30 patients typically had polyarthritis, and those with PsA or SpA often had previous psoriasis, axial involvement, or enthesitis. In the comparison group of 43 patients with LA, the usual clinical picture was monoarticular knee arthritis, without prior EM. Most of the patients with systemic autoimmune joint disorders were positive for <jats:italic>B burgdorferi<\/jats:italic> IgG antibodies, as detected by enzyme\u2010linked immunosorbent assay, but had significantly lower titers and lower frequencies of Lyme disease\u2013associated autoantibodies than patients with LA. Prior to our evaluation, these patients had often received additional antibiotics for presumed LA, without benefit. We prescribed antiinflammatory agents, most commonly disease\u2010modifying antirheumatic drugs, resulting in improvement.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Systemic autoimmune joint diseases (i.e., RA, PsA, SpA) may follow Lyme disease. Development of polyarthritis after antibiotic\u2010treated EM, previous psoriasis, or low\u2010titer <jats:italic>B burgdorferi<\/jats:italic> antibodies may provide insight into the correct diagnosis.<\/jats:p><\/jats:sec>","DOI":"10.1002\/art.39866","type":"journal-article","created":{"date-parts":[[2016,9,16]],"date-time":"2016-09-16T17:52:39Z","timestamp":1474048359000},"page":"194-202","source":"Crossref","is-referenced-by-count":64,"title":["Autoimmune Arthritides, Rheumatoid Arthritis, Psoriatic Arthritis, or Peripheral Spondyloarthritis Following Lyme Disease"],"prefix":"10.1002","volume":"69","author":[{"given":"Sheila L.","family":"Arvikar","sequence":"first","affiliation":[{"name":"Massachusetts General Hospital Boston"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jameson T.","family":"Crowley","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital Boston"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine B.","family":"Sulka","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital Boston"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allen C.","family":"Steere","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital Boston"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,12,28]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780200102"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.38756"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198303313081301"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-107-5-725"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-86-6-685"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.idc.2015.02.004"},{"key":"e_1_2_7_8_1","first-page":"590","article-title":"Recommendations for test performance and interpretation from the Second National Conference on Serologic Diagnosis of Lyme Disease","volume":"44","author":"Centers for Disease Control and Prevention (CDC)","year":"1995","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1086\/589242"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.22131"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1084\/jem.20052471"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.34383"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.27468"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.37910"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.37732"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1074\/mcp.M110.002477"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.38618"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiv310"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clim.2015.07.005"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaut.2016.02.005"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.thromres.2014.11.034"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/anr.1780320902"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.27584"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.21972"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2010.133645"},{"key":"e_1_2_7_26_1","first-page":"1","article-title":"Case definitions for public health surveillance","volume":"39","author":"Wharton M","year":"1990","journal-title":"MMWR Recomm Rep"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/167.2.392"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1186\/ar4289"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.140137"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10067-011-1692-7"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.21575"},{"key":"e_1_2_7_32_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.22185"},{"key":"e_1_2_7_33_1","doi-asserted-by":"publisher","DOI":"10.1086\/508667"},{"key":"e_1_2_7_34_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid2109.150417"},{"key":"e_1_2_7_35_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.27425"},{"key":"e_1_2_7_36_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780311004"},{"key":"e_1_2_7_37_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.20018"},{"key":"e_1_2_7_38_1","first-page":"779","article-title":"Preclinical rheumatoid arthritis: progress toward prevention [review]. 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