Haller E M, Langmann G, Langmann A, Lerchner H
Universitäts-Augenklinik, Graz, Osterreich.
Fortschr Ophthalmol. 1991;88(3):248-51.
We report three patients with recurrent Chlamydia-associated conjunctivitis. The clinical course of the Chlamydial infection was documented by positive conjunctival smears (direct immunofluorescence staining) and the evaluation of the IgA-titer in the sera (immunoperoxidase assay). The recovery of the ocular symptoms after therapy onset correlated well with the negative results of the conjunctival smears and the decrease in IgA level in the sera. The recurrence of the conjunctivitis was accompanied by an increase in the IgA titer in the sera of all three patients and the presence of Chlamydial elementary bodies in the conjunctival scrapings in two cases. Three patients showed immunologic pecularities: two had an allergic diathesis; the third patient developed Wegener disease 3 months after the onset of ocular inflammation. Inclusion bodies or Chlamydial DNA can persist in conjunctival cells. Anderson suggested that a recurrence of active Chlamydial infection may be induced by external causes, which lead to reconstitution of elementary bodies from the persisting DNA. The extraordinary immune situation of our patients might be one cause of the recurrent conjunctivitis.
我们报告了3例复发性衣原体相关性结膜炎患者。通过结膜涂片阳性（直接免疫荧光染色）及血清中IgA滴度评估（免疫过氧化物酶测定）记录衣原体感染的临床过程。治疗开始后眼部症状的缓解与结膜涂片阴性结果及血清中IgA水平下降密切相关。所有3例患者结膜炎复发均伴有血清中IgA滴度升高，其中2例结膜刮片中存在衣原体原体。3例患者表现出免疫学异常：2例有过敏体质；第3例患者在眼部炎症发作3个月后患上韦格纳病。包涵体或衣原体DNA可在结膜细胞中持续存在。安德森认为，外部因素可能诱发活动性衣原体感染复发，这些因素导致持续存在的DNA重新形成原体。患者特殊的免疫状况可能是结膜炎复发的原因之一。
