[The results of the dynamic observation of patients with reactive Yersinia arthritis]. / Rezul'taty dinamicheskogo nabliudeniia bol'nykh reaktivnym iersinioznym artritom.

As many as 50 patients with reactive Yersinia arthritis were followed up. There were 4 men and 46 women. The mean age of the patients was 31.1 yr. The mean follow-up period was 30.8 months. In 72% of the cases, the disease was preceded by diarrhea. During the first examination, mono-oligoarthritis was detected in 78% of the patients. Extra-articular alterations (damage of muscles, ligaments, heart, skin changes, etc) were also recorded. The results of bacteriological analyses were positive in 22 out of the 50 patients. In 16 persons, Yersinia might be cultivated from the different biological media: blood, feces, urine, fauces, and synovial fluid. In 47 persons, arthritis took a chronic course. Persistence of antibodies of the types 03 and 09 seen for many years merits attention. Monoclonal anti-Yersinia antibodies were also detectable repeatedly. In 8 patients, in whom Yersinia were cultivated from a lot of the biological media, the disease ran an especially grave course. The role of circulating specific antibodies in patients with Yersinia arthritis and the trigger role they may play in the development of RA and ankylosing spondylarthritis requires further discussion.

[Clinico-immunologic characteristics of complicated and uncomplicated yersiniosis]. / Kliniko-immunologicheskaia kharakteristika oslozhennogo i neoslozhnennogo iersinioza.

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.