Grasedyck K, Heesemann J
Medizinische Kernklinik und Poliklinik, Universität Hamburg.
Z Rheumatol. 1987 Jul-Aug;46(4):179-82.
Commonly-used serological methods for the determination of Yersinia antibodies are based on the presence of agglutinins, which are frequently absent or of low titer when arthritis begins. Stool cultures are usually negative at that time, so many Yersinia infections are underdiagnosed. On the other hand, significant agglutinin titers, of diagnostic value, become frequently minimised because of cross reactivity with Yersinia and other gram-negative bacteria. With the immunoblot-technique, using specific virulence-associated antigens and the detection of class-specific antibodies, clear statements are possible about whether there is a recent or an old Yersinia infection. As Yersinia arthritis may have an acute start and a protracted course over months, an exact diagnosis is essential for therapy and prognosis, as well as for answering the question of whether there is acute exacerbation of a preexisting rheumatoid illness of an additional infectious arthritis.
常用的用于检测耶尔森菌抗体的血清学方法基于凝集素的存在,而在关节炎开始时凝集素常常缺失或效价较低。此时粪便培养通常为阴性,因此许多耶尔森菌感染未得到充分诊断。另一方面,由于与耶尔森菌及其他革兰氏阴性菌存在交叉反应,具有诊断价值的显著凝集素效价常常被低估。采用免疫印迹技术,利用特定的毒力相关抗原并检测类别特异性抗体,就有可能明确判断是否存在近期或既往的耶尔森菌感染。由于耶尔森菌关节炎可能急性起病并持续数月,准确诊断对于治疗和预后至关重要,对于回答是否存在既往类风湿疾病急性加重或是否为另一种感染性关节炎的问题也至关重要。