Bas S, Cunningham T, Kvien T K, Glennås A, Melby K, Vischer T L
Division of Rheumatology, University Hospital, Geneva, Switzerland.
Br J Rheumatol. 1996 Jun;35(6):542-7. doi: 10.1093/rheumatology/35.6.542.
In clinical rheumatology, the diagnosis of Chlamydia reactive arthritis is difficult because an incomplete form of the disease can closely resemble an undifferentiated seronegative mono/oligoarthritis. We investigated whether measuring specific isotypes of anti-Chlamydia antibodies in serum can improve the diagnosis, by comparing such antibody concentrations in the serum of patients with well-defined disease, i.e. Chlamydia trachomatis sexually acquired reactive arthritis (CT-SARA), with other arthritides. Antibody levels were determined by enzyme-linked immunosorbent assay (ELISA). When considering two different isotypes and their combination, the best sensitivity (63%) was obtained for IgM and/or IgA results with a specificity of 81%. The patients with CT-SARA and SARA had the highest levels of antibodies of all isotypes tested. It is concluded that, in our experimental conditions, only very high values of specific isotypes could indicate a diagnosis of Chlamydia reactive arthritis.
在临床风湿病学中，衣原体反应性关节炎的诊断较为困难，因为该疾病的不完全形式可能与未分化的血清阴性单/寡关节炎极为相似。我们通过比较明确诊断为疾病的患者（即沙眼衣原体性获得性反应性关节炎（CT-SARA））血清中的抗衣原体抗体特定亚型浓度与其他关节炎患者的此类抗体浓度，来研究检测血清中抗衣原体抗体的特定亚型是否能改善诊断。抗体水平通过酶联免疫吸附测定（ELISA）来确定。当考虑两种不同的亚型及其组合时，IgM和/或IgA结果的最佳敏感性为63%，特异性为81%。在所有检测的亚型中，CT-SARA和SARA患者的抗体水平最高。得出的结论是，在我们的实验条件下，只有特定亚型的非常高的值才能表明衣原体反应性关节炎的诊断。
