[Joint manifestations and Yersinia pseudotuberculosis. Correlation between the clinical and biological aspects]

The authors attempt to evaluate the specificity of Yersinia pseudotuberculosis (YPT) serology on the basis of 94 new cases of aseptic joint lesions associated with serology considered to be positive. The cases selected from the file of the International Reference Centre for Yersinioses (Institut Pasteur, Paris, Prof. H.H. Mollaret), were divided into 4 groups: group A (n = 46) where the joint lesions had no proven aetiology and the positive YPT serology makes the diagnosis of Yersiniosis possible; group B (n = 24) where the joint lesions had a precise aetiology other than yersiniosis; group C (n = 11) with cases of erythema nodosa with arthralgia and group D (n = 11) with cases of erythema unusual cases. Comparison of the results of serology in the 4 groups reveals that the serodiagnosis is not discriminative and that serotypes II and/ or IV are involved in more than 80 per cent of cases. At the present time, the authors believe that YPT infection, especially types II and IV, can not be confirmed purely on the basis of serological data, as they are in discordance with the epidemiology of the disease; the interpretation of the results in hampered by a twofold difficulty: the determination of the threshold of positivity and the existence of crossed reactions. Finally, the serology is contradicted in certain cases by the demonstration of another pathogenesis.