[Clinico-immunologic characteristics of complicated and uncomplicated yersiniosis]

Asymmetric affection of the major lower limb joints is a characteristic feature of the joint syndrome in yersiniosis-associated arthritis. The sacroiliac articulations are frequently (47% cases) involved. In addition, yersiniosis-associated arthritis concurs with the signs and symptoms of systemic disease--gastroenterocolitis, myocardiopathy and myocarditis, erythema nodosum, hepatitis, urethritis, conjunctivitis, myositis and myalgia, enteropathy; changes in the CNS typical for the astheno-neurotic syndrome are frequently present. Comparison of the immunological assay data in complicated and uncomplicated yersiniosis shows equally high levels of IgG and CIC. High anti-DNA antibody titres are more frequently found in the serum of uncomplicated yersiniosis patients. ELISA quantitation of specific IgA, IgM, and IgG class antibodies in yersiniosis-associated arthritis patients demonstrated persistence of all the three antibody classes or of IgA-IgG combination in cases with most severe of the joint syndrome. In the presence of cardiac disease, patients were found to have high titres of antibodies reactive with the cardiac interstitial tissue, while in authentically diagnosed myocarditis cases with the sarcolemma. The investigation findings strongly suggest a high degree of involvement of immune and autoimmune processes in the pathogenesis of arthritides secondary to Yersinia infection.