A survey of acute and chronic disease associated with Yersinia enterocolitica infection. A Norwegian 10-year follow-up study on 458 hospitalized patients

Our plain-English summary of A survey of acute and chronic disease associated with Yersinia enterocolitica infection. A Norwegian 10-year follow-up study on 458 hospitalized patients, by A. Saebø, J. Lassen (Scandinavian Journal of Infectious Diseases, 1991).

The study

• Authors: A. Saebø, J. Lassen
• Journal: Scandinavian Journal of Infectious Diseases
• Published: 1991;23(5):517-27
• Type of article: Review
• Cited by: 23 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

The aim of the present study was to further elucidate acute and chronic manifestations of Yersinia enterocolitica infection. During the period 1974-83, 458 hospitalized patients were diagnosed by antibody response and/or isolation of the microorganism. 64 patients had suffered from chronic conditions as rheumatic disease, inflammatory bowel disease, hepatitis, nephritis or thyroid disease for some time. Acute hepatic, renal, cardiac, pulmonary, pancreatic or neurologic involvement were observed in a substantial portion of patients; several had multiorgan disease. Acute insulin-dependent diabetes was seen in 2 patients, malignant mesothelioma in 2, and specific lymph node inflammation in 1. The patients were followed for 4-14 years (1987). 36/160 readmitted patients had abdominal pain and 26 had diarrhea; chronic colitis was demonstrated in 4. Some patients developed rheumatic conditions; others developed chronic disease of liver, kidneys, heart, pancreas, thyroid or nervous system. Chronic liver disease, in 22 patients, was correlated with positive tests for antinuclear antibody and rheumatoid factor; and might influence development of malignant disease, and mortality. A variety of acute and chronic clinical pictures may be associated with Y. enterocolitica infection, and further clinical research is required in this field.

In plain English

This Norwegian study is labelled a review article by the journal, but it reports the authors' own patient data. It followed 458 people admitted to 52 hospitals between 1974 and 1983 with infection by the bacterium Yersinia enterocolitica, diagnosed from stool samples or antibody tests. Patients were followed until June 1987, for 4 to 14 years. The study is about this infection, not asbestos. Two female patients had malignant mesothelioma: one pericardiac (around the heart) with lung metastases, and one pleural. Both died after a few months. The authors wrote that these women had no previous asbestos exposure and that promotion of the tumors by the infection should not be disregarded. These are two individual cases, not a rate. Of 160 readmitted patients, 36 had abdominal pain and 26 had diarrhea. Chronic liver disease, seen in 22 patients, was linked to positive antinuclear antibody and rheumatoid factor tests, to more cancers (3/22 vs 9/422) and to more deaths. The authors concluded that many illnesses probably may be connected with the infection. They cautioned that cancer frequency may not differ from that of the Norwegian population and that liver function was not measured in all patients.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Retrospective follow-up study of hospitalized patients with laboratory-diagnosed Y. enterocolitica infection, using hospital records and a mailed questionnaire (labelled a review article in the journal header)
• Who was studied: 458 hospitalized patients (202 males, 256 females) admitted to 52 Norwegian hospitals and diagnosed during 1974-1983 (95 of 553 diagnosed patients were excluded for insufficient or missing hospital files); followed until June 30, 1987
• Exposure: Infection with Yersinia enterocolitica (mostly serotype O:3), diagnosed by isolation from feces and/or antibody response; asbestos was not the exposure studied
• Main results:
  • Two female patients developed malignant mesothelioma, one pericardiac with pulmonary metastases and one pleural; both died after a few months
  • The authors reported that both mesothelioma patients were women without previous asbestos exposure
  • At the time of diagnosis, 64 patients (23 males and 41 females) already had particular chronic diseases
  • Among 160 readmitted patients, 26 had diarrhea and 36 had abdominal pain; chronic colitis was verified by biopsy in 4 males
  • Among patients examined, antinuclear antibody was found in 6/8 with chronic liver disease vs 2/39 with normal liver function (p less than 0.00015)
  • Of 444 patients at risk, 12 developed malignant disease; frequency was 3/22 in patients with chronic liver disease vs 9/422 in those with no indication of liver disease (p less than 0.04)
  • Excluding 4 deaths, 10/22 patients in the liver disease group (45.5%) and 26/426 with no indication of liver disease (6.1%) died during observation (p less than 0.00001)
  • 24 Bergen University Hospital patients had a significantly lowered mean serum level of complement component C4 compared with first degree relatives and controls without Y. enterocolitica antibodies
• The authors' conclusion: The authors concluded that a variety of acute and chronic clinical pictures probably may be connected with Y. enterocolitica infection, and that prospective studies are required. Regarding mesothelioma, they suggested that promotion by the infection should not be disregarded.
• Limitations the authors state:
  • The extent of examinations varied between hospitals and with seriousness of disease, so reported observations are minimum numbers
  • Evidence of chronic yersiniosis is circumstantial for a considerable portion of readmitted patients
  • The frequency of malignant disease may not differ from that in Norwegian society, and liver function was not measured in all patients, so the liver-cancer and liver-death correlations should be treated with caution

Topics

Medical terms in this study, explained in our Lexicon: Mesothelioma, Inflammation.

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