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Yersinia enterocolitica biotype 1A: a possible new trigger of reactive arthritis

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Abstract

Yersinia enterocolitica (YE) biotype 1A is generally considered non-pathogenic, and the role of it in causing reactive musculoskeletal complications is unclear. We evaluated the capability of YE biotype 1A to induce reactive arthritis (ReA) and other reactive musculoskeletal symptoms. Analysis of self-reported musculoskeletal symptoms was supplemented with a telephone interview (with a permission to acquire copies of patient files from a local physician or hospital) and/or clinical examination of subjects with recent musculoskeletal symptoms after a positive stool culture for YE. The diagnoses of ReA and reactive tendinitis and enthesitis (ReTe) were defined as “definite” when based on clinical examination and/or on interview by phone and “probable” when based solely on the questionnaire. Of 120 subjects, who reported musculoskeletal symptoms, 100 were included in the final analysis. Among these 100 patients, 68% had YE biotype 1A, 16% YE bio/serotype 4, and 1% biotype 2 infection; the remaining 15% had different YE-like strains or a non-biotypable strain. Of the 21 patients with ReA and of the 14 patients with ReTe, the diagnosis was definite in 9 and 7 patients and probable in 12 and 7 patients, respectively. The clinical picture of ReA caused by YE biotype 1A was similar with other bio/serotypes of YE. The definite ReA due to YE biotype 1A occurred in middle-aged adults (5 men, 4 women) with the most frequently affected joints being the knees and ankles. We suggest that YE biotype 1A should be taken into account as a new trigger of ReA.

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Acknowledgements

We thank Kirsi Mäkisalo from the THL for her technical help in selecting the study population as well as study nurse Arja Kaarto from the HUCH.

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Authors and Affiliations

  1. Rheumatology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland

    Riitta Tuompo & Marjatta Leirisalo-Repo

  2. Department of Public Health, Hjelt Institute, University of Helsinki, Helsinki, Finland

    Timo Hannu

  3. Epidemiologic Surveillance and Response Unit, National Institute for Health and Welfare (THL), Helsinki, Finland

    Elisa Huovinen

  4. Bacteriology Unit, National Institute for Health and Welfare (THL), Helsinki, Finland

    Leila Sihvonen & Anja Siitonen

  5. Department of Rheumatology, Inflammation Center, Helsinki University Central Hospital, PO 372, 00029 HUS, Helsinki, Finland

    Riitta Tuompo

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  1. Riitta Tuompo
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Correspondence to Riitta Tuompo.

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Funding

This study was supported by the Helsinki University Central Hospital Fund, Scandinavian Rheumatology Research Fund and Finnish Rheumatology Research Fund.

Conflict of interest

Author Riitta Tuompo has received research grants from Scandinavian Rheumatology Research Fund and Finnish Rheumatology Research Fund and Helsinki University Central Hospital Fund. Author Marjatta Leirisalo-Repo has received grant from Helsinki University Hospital Funds and consultancy fees from Pfizer, Lilly and Boehringer Ingelheim and payment for lectures from Roche and BristolMyersSquibb. Author Timo Hannu declares that he has no conflict of interest. Author Elisa Huovinen declares that she has no conflict of interest. Author Leila Sihvonen declares that she has no conflict of interest. Author Anja Siitonen declares that she has no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

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Tuompo, R., Hannu, T., Huovinen, E. et al. Yersinia enterocolitica biotype 1A: a possible new trigger of reactive arthritis. Rheumatol Int 37, 1863–1869 (2017). https://doi.org/10.1007/s00296-017-3816-0

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  • DOI: https://doi.org/10.1007/s00296-017-3816-0

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