REVIEW - The history of bacteriologic concepts of rheumatic fever and RA

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Semin Arthritis Rheum. 2006 Oct;36(2):109-23. Epub 2006 Jul 13.

The history of bacteriologic concepts of rheumatic fever and rheumatoid

arthritis.

Department of Medicine, University of Pittsburgh School of Medicine,

Pittsburgh, PA, USA. benedek@...

OBJECTIVES: Review of the development of etiologic and pathogenetic concepts

of rheumatic fever (RF) and rheumatoid arthritis (RA) from the beginning of

clinical bacteriology to the discovery of antibiotics. METHOD: Analysis of

English and German language publications pertaining to bacteriology and

" rheumatism " between the 1870s and 1940s. RESULTS: Early in the 20th century

there was a widely held belief that a microbial cause would eventually be

found for most diseases. This encouraged pursuit of the intermittent

findings of positive blood and synovial fluid cultures in cases of RF and

RA. Development of a streptococcal agglutination test supported the

erroneous belief that RA is a streptococcal infection, while the

simultaneous development of other immunologic tests for streptococci

suggested that a hemolytic streptococcus was etiologic in RF. Table 1

provides a chronology of major events supporting and retarding resolutions.

CONCLUSIONS: Much of the conflicting data and inferences regarding the

etiology of RF and RA can be attributed to the absence or inadequacy of

controls in observations of clinical cohorts and laboratory experiments.

PMID: 16884972

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed & cmd=Retrieve & dopt=Abstra\

ctPlus & list_uids=16884972

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