Rheumatology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Department of Rheumatology, Inflammation Center, Helsinki University Central Hospital, PO 372, 00029 HUS, Helsinki, Finland.
Rheumatol Int. 2017 Nov;37(11):1863-1869. doi: 10.1007/s00296-017-3816-0. Epub 2017 Sep 16.
Yersinia enterocolitica (YE) biotype 1A is generally considered non-pathogenic, and the role of it in causing reactive musculoskeletal complications is unclear. We evaluated the capability of YE biotype 1A to induce reactive arthritis (ReA) and other reactive musculoskeletal symptoms. Analysis of self-reported musculoskeletal symptoms was supplemented with a telephone interview (with a permission to acquire copies of patient files from a local physician or hospital) and/or clinical examination of subjects with recent musculoskeletal symptoms after a positive stool culture for YE. The diagnoses of ReA and reactive tendinitis and enthesitis (ReTe) were defined as "definite" when based on clinical examination and/or on interview by phone and "probable" when based solely on the questionnaire. Of 120 subjects, who reported musculoskeletal symptoms, 100 were included in the final analysis. Among these 100 patients, 68% had YE biotype 1A, 16% YE bio/serotype 4, and 1% biotype 2 infection; the remaining 15% had different YE-like strains or a non-biotypable strain. Of the 21 patients with ReA and of the 14 patients with ReTe, the diagnosis was definite in 9 and 7 patients and probable in 12 and 7 patients, respectively. The clinical picture of ReA caused by YE biotype 1A was similar with other bio/serotypes of YE. The definite ReA due to YE biotype 1A occurred in middle-aged adults (5 men, 4 women) with the most frequently affected joints being the knees and ankles. We suggest that YE biotype 1A should be taken into account as a new trigger of ReA.
小肠结肠炎耶尔森菌（YE）生物型 1A 通常被认为是非致病性的，其在引起反应性肌肉骨骼并发症中的作用尚不清楚。我们评估了 YE 生物型 1A 诱导反应性关节炎（ReA）和其他反应性肌肉骨骼症状的能力。对自述肌肉骨骼症状的分析辅以电话访谈（经当地医生或医院许可获取患者档案副本）和/或对近期出现肌肉骨骼症状的患者进行临床检查，这些症状在 YE 粪便培养阳性后发生。ReA 和反应性肌腱炎和附着点炎（ReTe）的诊断在基于临床检查和/或电话访谈时为“明确”，在仅基于问卷时为“可能”。在报告肌肉骨骼症状的 120 名受试者中，有 100 名被纳入最终分析。在这 100 名患者中，68%有 YE 生物型 1A，16%有 YE 生物/血清型 4，1%有生物型 2 感染；其余 15%有不同的耶尔森菌样菌株或不可分型菌株。在 21 名 ReA 患者和 14 名 ReTe 患者中，分别有 9 名和 7 名患者的诊断为明确，12 名和 7 名患者的诊断为可能。YE 生物型 1A 引起的 ReA 的临床特征与其他 YE 生物/血清型相似。由 YE 生物型 1A 引起的明确 ReA 发生在中年成年人（5 男，4 女）中，最常受累的关节是膝盖和脚踝。我们建议将 YE 生物型 1A 视为 ReA 的新触发因素。
