Yersinia enterocolitica infection and sarcoidosis. A report of seven cases

Sarcoidosis of recent onset was diagnosed during a Yersinia enterocolitica infection in seven patients at the Copenhagen County Hospitals during a 3 1/2 year period. In all cases the diagnosis was made from clinical symptoms and confirmed by chest X-ray and biopsy. In five of the patients a fourfold rise or decrease was measured in the antibody titre against Yersinia enterocolitica, serotype 3, confirming an acute infection. In another two patients this titre remained significantly elevated greater than or equal to 80, indicating chronic infection. Five patients experienced joint symptoms and four erythema nodosum, symptoms common to both yersiniosis and sarcoidosis. A follow-up examination 14 to 41 months after the debut of sarcoidosis showed total remission (including chest X-ray and respiratory function) in five of the seven patients. Recent research has shown that Yersinia enterocolitica following the early stage of the infection causes granulomatous lesions in lymph follicles, and this aetiology should thus be considered as a differential diagnosis to sarcoidosis.