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October 26, 1984


JAMA. 1984;252(16):2201-2205. doi:10.1001/jama.1984.03350160069021

... interferons, interleukins, arachidonic acid metabolites, and cell-derived chemotactic factors.

New knowledge about rheumatic diseases has been generated at an ever-increasing pace. Comparison of the first edition of Arthritis and Allied Conditions, edited by Bernard Comroe (1940), with the subsequent nine editions provides ample documentation. A few recent highlights are discussed herein.

Perhaps the most striking recent discovery is the spirochetal etiology of Lyme arthritis, now more properly termed "Lyme disease."1 This syndrome was first detected in Lyme, Conn, because of a close geographic clustering of children with what was thought to be juvenile rheumatoid arthritis. The illness begins in warm weather as a characteristic rash, consisting of an expanding reddened area with central clearing and induration called "erythema chronica migrans." This lesion (stage 1) is sometimes followed weeks to months later by cardiac or neurological symptoms (stage 2) and weeks to years later by arthritis (stage 3). Lyme disease is