Chronic Lyme arthritis. Clinical and immunogenetic differentiation from rheumatoid arthritis.
Chronic Lyme arthritis. Clinical and immunogenetic differentiation from rheumatoid arthritis.
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慢性莱姆关节炎。
DOI：
10.7326/0003-4819-90-6-896
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发表时间：
1979
影响因子：
39.2
通讯作者：
S. Malawista
中科院分区：
文献类型：
--
作者：
A. Steere;A. Gibofsky;M. Patarroyo;R. Winchester;J. Hardin;S. Malawista
10例莱姆关节炎患者出现单侧或双侧膝关节慢性受累。莱姆病关节炎的诊断依据为：慢性游走性红斑（6例）;居住在康涅狄格州莱姆病（8例）;夏季和初秋季节性发作（9例）;早期短期复发性发作（9例）;无类风湿因子（9例）;无对称性多关节炎、晨僵、皮下结节或抗核抗体（全部）。5例患者进行了滑膜切除术;所有患者均存在血管翳形成和基础软骨侵蚀。10名患者中有7名患者具有相同的B细胞同种异体抗原DRw 2（正常对照组的频率为22% [P <0.005]），但与类风湿关节炎相关的同种异体抗原的频率没有增加。慢性莱姆关节炎是一种明显的蜱传播感染的结果，在病理上类似于类风湿性关节炎，但在关节前和免疫遗传学特征上通常与之不同。
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.