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How can doctors determine if patients with systemic autoimmune joint disease following Lyme disease don’t have a persistent infection?

Doctors at Massachusetts General Hospital have described a series of 30 patients who developed systemic autoimmune joint disease following Lyme disease. "Fifteen had rheumatoid arthritis (RA), 13 had psoriatic arthritis (PsA), and 2 had peripheral spondyloarthropathy (SpA)," according to Arvikar and colleagues. [1]