Lebech A M, Hansen K, Pancholi P, Sloan L M, Magera J M, Persing D H
Department of Clinical Biochemistry, Statens Seruminstitut, University Hospital Hvidovre, Copenhagen, Denmark.
Scand J Infect Dis. 1998;30(2):173-6. doi: 10.1080/003655498750003582.
Human Granulocytic Ehrlichiosis (HGE) is a recently described human illness in the US which manifests as fever, myalgia and headache combined with pancytopenia and elevated concentrations of hepatic transaminases. Genetic analyses indicate that the agent of HGE appears to be an Ehrlichia species that is closely related to E. equi and E. phagocytophila. Ixodes dammini and I. scapularis were identified as potential vectors of HGE. Ixodes ticks are also the vector of Borrelia burgdorferi, the agent of Lyme borreliosis. The presence of antibodies against Ehrlichia in 132 sera from Danish patients with definite Lyme neuroborreliosis were examined in order to provide immunoserologic evidence of this infection in Denmark. Patients with Lyme neuroborreliosis were chosen as a test cohort, as these patients had been infested by a tick sufficient for transmission of B. burgdorferi. All had cerebrospinal fluid lymphocytic pleocytosis. As controls, serum samples from 50 healthy Danish blood donors were included. Of the 132 patients with Lyme neuroborreliosis, 5 (3.8%) reacted with the E. equi antigen substrate at titres 1:128. None of the blood donors were found seropositive for E. equi. At least 2 of the patients found seropositive for HGE constituted probable cases of HGE with E. equi antibody titres of at least 80 combined with fever, headache and myalgias. However, in no cases were we able to detect the presence of the HGE agent in the serum by PCR. We conclude that human exposure to granulocytic Ehrlichiae species may also occur in Europe, although further studies will be necessary to document active infection with these potential pathogens.
人粒细胞埃立克体病（HGE）是美国最近发现的一种人类疾病，其症状表现为发热、肌痛、头痛，伴有全血细胞减少和肝转氨酶浓度升高。基因分析表明，HGE的病原体似乎是一种与马埃立克体和嗜吞噬细胞埃立克体密切相关的埃立克体属物种。达氏硬蜱和肩突硬蜱被确定为HGE的潜在传播媒介。硬蜱也是莱姆病病原体伯氏疏螺旋体的传播媒介。检测了132例确诊为莱姆神经疏螺旋体病的丹麦患者血清中抗埃立克体抗体，以提供丹麦这种感染的免疫血清学证据。选择莱姆神经疏螺旋体病患者作为检测队列，因为这些患者曾被足以传播伯氏疏螺旋体的蜱叮咬过。所有患者脑脊液中淋巴细胞均有增多。作为对照，纳入了50名健康丹麦献血者的血清样本。在132例莱姆神经疏螺旋体病患者中，5例（3.8%）与马埃立克体抗原底物反应，滴度为1:128。未发现献血者血清中马埃立克体呈阳性。至少2例血清中HGE呈阳性的患者可能患有HGE，马埃立克体抗体滴度至少为80，并伴有发热、头痛和肌痛。然而，我们未能通过PCR在血清中检测到HGE病原体的存在。我们得出结论，在欧洲也可能发生人类接触粒细胞埃立克体属物种的情况，尽管需要进一步研究来证实这些潜在病原体的活动性感染。
