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The amber theory of Lyme arthritis: initial description and clinical implications.

Abstract

Lyme arthritis differs in many respects from other bacterial causes of arthritis. Based on an observation made for a patient with Lyme arthritis, we propose that the pathogenesis of joint swelling in Lyme arthritis is due to the introduction into the joint space of non-viable spirochetes or more likely spirochetal debris enmeshed in a host-derived fibrinous or collagenous matrix. This "amber" hypothesis can account for the clinical and laboratory features of Lyme arthritis and is amenable to experimental validation. Validation would directly impact the clinical management of patients with Lyme arthritis.

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  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    Division of Infectious Diseases of the Department of Medicine, New York Medical College, Valhalla, NY 10595, USA. gary_wormser@nymc.edu

    ,

    Source

    Clinical rheumatology 31:6 2012 Jun pg 989-94

    MeSH

    Anti-Bacterial Agents
    Biofilms
    Borrelia burgdorferi
    Collagen
    Humans
    Inflammation
    Joint Diseases
    Joints
    Lyme Disease
    Models, Biological
    Models, Theoretical
    Rheumatology

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    22411576

    Citation

    TY - JOUR T1 - The amber theory of Lyme arthritis: initial description and clinical implications. AU - Wormser,Gary P, AU - Nadelman,Robert B, AU - Schwartz,Ira, Y1 - 2012/03/13/ PY - 2011/10/31/received PY - 2012/2/18/accepted PY - 2012/1/24/revised PY - 2012/3/13/aheadofprint PY - 2012/3/14/entrez PY - 2012/3/14/pubmed PY - 2012/10/12/medline SP - 989 EP - 94 JF - Clinical rheumatology JO - Clin. Rheumatol. VL - 31 IS - 6 N2 - Lyme arthritis differs in many respects from other bacterial causes of arthritis. Based on an observation made for a patient with Lyme arthritis, we propose that the pathogenesis of joint swelling in Lyme arthritis is due to the introduction into the joint space of non-viable spirochetes or more likely spirochetal debris enmeshed in a host-derived fibrinous or collagenous matrix. This "amber" hypothesis can account for the clinical and laboratory features of Lyme arthritis and is amenable to experimental validation. Validation would directly impact the clinical management of patients with Lyme arthritis. SN - 1434-9949 UR - https://www.unboundmedicine.com/medline/citation/22411576/abstract/The_amber_theory_of_Lyme_arthritis:_initial_description_and_clinical_implications_ L2 - http://dx.doi.org/10.1007/s10067-012-1964-x ER -