Rothova A, Kerkhoff F, Hooft H J, Ossewaarde J M
Department of Ophthalmology, F.C. Donders Institute, Academic Hospital Utrecht, The Netherlands.
Retina. 1998;18(4):348-55. doi: 10.1097/00006982-199807000-00010.
To determine the role of Bartonella henselae in intraocular inflammatory disease and identify its clinical features.
We retrospectively determined the serum immunoglobulin (Ig)G and IgM antibodies against B. henselae and Bartonella quintana by enzyme immunoassays in stored sera of 138 consecutive newly referred patients with uveitis who, during the acute stage of their ocular disease, underwent a standardized screening protocol to determine the cause of uveitis.
For the entire series, the frequency of high positive levels of IgG (above 1:900) or IgM (above 1:300) antibody against B. henselae was 6% (8/138) and 3% (4/138), respectively. Except for cross-reactions between B. henselae and B. quintana, we did not find additional evidence for cross-reactions among the various bacteria tested (Coxiella burnetii and Chlamydia pneumoniae). All patients with proven infectious uveitis (n = 21) and those with established uveitic entities (n = 37) had negative B. henselae serology. High positive IgG levels were observed in 9% of patients (5/54) with unknown cause of uveitis, in two subjects with human leukocyte antigen (HLA)-B27 positive uveitis, and in one with sarcoidosis. Five patients with uveitis of unknown origin and highly elevated IgG levels against B. henselae exhibited clinical features characterized by papillitis with surrounding retinal focal lesions or edema.
The serologic and clinical data indicate that uveitis in seropositive cases may be caused by B. henselae. We do not recommend including testing for B. henselae in initial screening of patients with uveitis, but consider it worthwhile for those with papillitis and screening results within normal limits.
确定汉赛巴尔通体在眼内炎性疾病中的作用并明确其临床特征。
我们采用酶免疫分析法，对138例连续新转诊的葡萄膜炎患者储存血清中的抗汉赛巴尔通体和五日热巴尔通体的血清免疫球蛋白（Ig）G和IgM抗体进行回顾性检测。这些患者在眼病急性期接受了标准化筛查方案以确定葡萄膜炎病因。
在整个系列中，抗汉赛巴尔通体IgG（高于1:900）或IgM（高于1:300）抗体高阳性水平的频率分别为6%（8/138）和3%（4/138）。除了汉赛巴尔通体和五日热巴尔通体之间的交叉反应外，我们未发现所检测的各种细菌（伯氏考克斯体和肺炎衣原体）之间存在其他交叉反应的证据。所有确诊为感染性葡萄膜炎的患者（n = 21）和已确诊葡萄膜炎类型的患者（n = 37）汉赛巴尔通体血清学检测均为阴性。在9%病因不明的葡萄膜炎患者（5/54）、2例人类白细胞抗原（HLA）-B27阳性葡萄膜炎患者和1例结节病患者中观察到IgG高阳性水平。5例葡萄膜炎病因不明且抗汉赛巴尔通体IgG水平显著升高的患者表现出以视乳头炎伴周围视网膜局灶性病变或水肿为特征的临床症状。
血清学和临床数据表明，血清反应阳性病例中的葡萄膜炎可能由汉赛巴尔通体引起。我们不建议在葡萄膜炎患者的初始筛查中进行汉赛巴尔通体检测，但对于患有视乳头炎且筛查结果在正常范围内的患者，认为检测是值得的。
