Systemic autoimmune joint diseases (ie, rheumatoid arthritis [RA], psoriatic arthritis [PsA], peripheral spondyloarthritis [SpA]) may follow Lyme disease, according to a recent study. Researchers reviewed records of all adult patients referred to a Lyme arthritis (LA) clinic over a 13-year period, in which there was a diagnosed systemic autoimmune joint disease following Lyme disease. They found:

• 30 patients were identified who had developed a new-onset systemic autoimmune joint disorder a median of 4 months after Lyme disease (usually manifested by erythema migrans [EM]).
• 15 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.
• Most of the patients with systemic autoimmune joint disorders were positive for B burgdorferi IgG antibodies, as detected by enzyme-linked immunosorbent assay, but had significantly lower titers and lower frequencies of Lyme disease–associated autoantibodies than patients with LA.