Inina L I, Ivanova M M, Akimova T F, Motovilov A A, Malov I V
Vestn Akad Med Nauk SSSR. 1989(6):60-4.
Asymmetric affection of the major lower limb joints is a characteristic feature of the joint syndrome in yersiniosis-associated arthritis. The sacroiliac articulations are frequently (47% cases) involved. In addition, yersiniosis-associated arthritis concurs with the signs and symptoms of systemic disease--gastroenterocolitis, myocardiopathy and myocarditis, erythema nodosum, hepatitis, urethritis, conjunctivitis, myositis and myalgia, enteropathy; changes in the CNS typical for the astheno-neurotic syndrome are frequently present. Comparison of the immunological assay data in complicated and uncomplicated yersiniosis shows equally high levels of IgG and CIC. High anti-DNA antibody titres are more frequently found in the serum of uncomplicated yersiniosis patients. ELISA quantitation of specific IgA, IgM, and IgG class antibodies in yersiniosis-associated arthritis patients demonstrated persistence of all the three antibody classes or of IgA-IgG combination in cases with most severe of the joint syndrome. In the presence of cardiac disease, patients were found to have high titres of antibodies reactive with the cardiac interstitial tissue, while in authentically diagnosed myocarditis cases with the sarcolemma. The investigation findings strongly suggest a high degree of involvement of immune and autoimmune processes in the pathogenesis of arthritides secondary to Yersinia infection.
主要下肢关节的不对称性受累是耶尔森菌病相关性关节炎关节综合征的一个特征性表现。骶髂关节常受累（47%的病例）。此外，耶尔森菌病相关性关节炎还伴有全身疾病的体征和症状——胃肠结肠炎、心肌病和心肌炎、结节性红斑、肝炎、尿道炎、结膜炎、肌炎和肌痛、肠病；常出现虚弱-神经症综合征典型的中枢神经系统改变。对复杂性和非复杂性耶尔森菌病的免疫测定数据进行比较，结果显示IgG和循环免疫复合物（CIC）水平同样较高。在非复杂性耶尔森菌病患者的血清中更常发现高抗DNA抗体滴度。对耶尔森菌病相关性关节炎患者的特异性IgA、IgM和IgG类抗体进行ELISA定量分析，结果表明，在关节综合征最严重的病例中，这三种抗体类或IgA-IgG组合持续存在。在存在心脏疾病的情况下，发现患者对心脏间质组织有高滴度的反应性抗体，而在确诊为心肌炎的病例中则对肌膜有高滴度反应性抗体。研究结果强烈提示免疫和自身免疫过程在耶尔森菌感染继发关节炎的发病机制中高度参与。
