Yersinia Enterocolitica and Thyroiditis – Results Back

[hopefulmama]

Hi all,

Just a brief update that may be helpful to others that suffer from thyroiditis.

In my last visit with Dr. F a few weeks ago I mentioned that I had read about a connection between Yersinia Enterocolitica and Hashimoto’s Thyroiditis (http://thyroid.about.com/cs/hashimotos/a/antibiotics.htm) and asked the good doctor if he would please test me for antibodies. Yersinia is treated with doxycycline (in combination with other abx) and I wondered if this could be the key to why my symptoms have been so improved on doxy but reverted to poor during the month he’d switched me to azithromycin alone.

Tonight Dr. F called my home at 9pm (bless him) to let me know that my results came back with a high positive for Yersinia Enterocolitica antibodies – far beyond equivocal.

I’m not sure how this will change my treatment plan, but I am excited to have another piece of the puzzle falling into place. While my lyme titers have always been extremely low (borderline equivocal) the mycoplasma, Group B Strep… and now Yersinia E are extremely high.

If there are others on the board who suffer from Hashimoto’s, perhaps consider getting a Yersinia test to find out if this is complicating your healing picture as well. Anyway, just one patient’s journey but I really hope it helps somebody!

All the best 🙂

A

p.s. I have been reading up on this and thought I should include the following information as it seems crucial for many of us including those with ankylosing spondylitis… just to show the connection between the bacteria and its manifestations. With proper treatment we should hopefully all be able to avoid negative outcomes!!!

From: http://home.online.no/~asaebo/clinical.htm
YERSINIA ENTEROCOLITICA INFECTION IN NORWAY
A study on prevalence, epidemiology, and acute and chronic manifestations.

Chronic manifestations. Clinical follow-up studies have documented that ankylosing spondylitis may develop subsequently to Y. enterocolitica infection , especially in patients presenting the histocompatibility antigen HLA-B27 (55, 56). An association between Y. enterocolitica infection and rheumatoid arthritis has further been suggested (57, 58).

Regarding abdominal disease, several previous r eports claim that sustained or recurrent diarrhea or abdominal pain may follow the acute Y. enterocolitica infection (5, 59, 60, 61). An association with chronic colitis or ulcerative colitis (UC) was suggested from clinical observa tions twenty years ago (38, 62), later were high frequencies of specific antibodies observed among patients with UC (58) and Crohn’s disease (CD) (63). In 1977, clinical observations made me suggested the possibility of chronic liver involvement (64), and during the following years reports of granulomatous hepatitis were added (65, 66, 67). Recently, virulent Y. enterocolitica has been identified by immunofluorescent techniques in a patient with chronic granulomatous hepatitis, and in patients with chronic intestinal disease (68). Acute glomerulonephritis seemingly may progress to chronic nephropathy (69). Associations with chronic thyroid disease (53), sarcoidosis-like conditions (54) and neurological disease (52) have been suggested. Clinical ob servations indicating development of chronic disease are mirrored by the demonstration of circulating immune complexes (70, 71), and deposits of immune complexes and complement component C3 in diseased tissue (69).

PAPER II.

Saebo A, Lassen J. A survey of acute and chronic disease associated with Yersinia enterocolitica infection. A Norwegian 10-year follow-up study on 458 hospitalized patients. Scand J Infect Dis 1991; 23: 517-527.

This paper give s an extensive survey of acute and chronic disease observed among 458 patients hospitalized with Y. enterocolitica infection.

Acute symptoms: 189 patients presented with uncomplicated arthritis, and 200 with diarrhea. These manifestations overla pped in 91 patients. 56 patients underwent abdominal surgery. Liver involvement was observed in 54 patients (12%). Renal, cardiac, pulmonary, pancreatic and neurologic involvement were observed with small but significant frequencies (8-16/458 patients = 1.75%-3.5%; SD 0.61%-0.86%), and often as components of multiorgan disease, which was observed in several patients. Other manifestations included erythema nodosum (in 60 patients), iridocyclitis, splenomegaly, deep venous thrombosis, thyroiditis, spontaneous abortion, chronic specific lymph node inflammation, adverse effect of iron, and septicaemia.

In addition to their acute symptoms, 64 patients had suffered from particular chronic conditions as rheumatic disease, inflammatory bowel disease, hepatitis, thyroid disease, neurologic disease, sarcoidosis or insulin-dependent diabetes for months or even years.

Arthritis and rheumatism: Among 160 patients who were readmitted (for Yersinia infection), 44 presented with uncomplicated arthritis, and nine suffered from severe sero-negative polyarthritis. When previously diagnosed patients were included, a total of 26 patients suffered from ankylosing spondylitis; at least 14 of them presented the histocompatibility antigen HLA-B 27. Totally 19 patients suffered from rheumatoid arthritis, and 11 from iridocyclitis. Development of ankylosing spondylitis subsequently to Y. enterocolitica infection, and especially in HLA-B27 positive patients, is well documented (55, 56); and an association with rheumatoid arthritis has been suggested (57, 58). Our observations confirm previous observations, as nearly 10% of our patients developed severe rheumatic disease. Also minor joint complaint may be commonly experienced, as 149/337 que stionnaire replyers, without rheumatic disease, at follow-up complained of arthralgia or joint swelling. Our observations support a previous contribution suggesting that the long term prognosis of Yersinia arthritis might be less favourable than pr eviously thought (85). Prolonged persistence of IgA antibodies to Y. enterocolitica has been demonstrated in patients who develop reactive arthritis (86). The antibody response is directed against both chromosomally and plasmid-encoded antigens, in dicating that the microorganism may hide within the host for a prolonged time (86, 87, 88, 89, 90). However, only bacterial degradation products, not whole bacteria, are present at the site of inflammation in reactive arthritis (91). Reduced levels of ery throcyte C3b receptor may contribute to the pathogenesis of reactive arthritis by affecting the clearance of immune complexes (92).

In a recent study on antibiotic treatment in Yersinia-associated spondyl-arthropathy, disappearance of IgA antibodies coincided with disappearance of virulent Y. enterocolitica in intestinal biopsies (93).

Thyroid disease: At first admission, two patients presented with acute thyroiditis, in one thyreotoxicosis prompted thyroid resection. Nine patients had thyroid disease diagnosed prior to first admission. During the follow-up period, another nine patients developed thyroid disease; two of them were hospitalized with acute thyroiditis. In the one, with high thyroid antibodies, microscopy of the resected thyroid showed Hashimoto’s thyroiditis (struma lymphomatosa); the other underwent tracheostomy because of laryngeal edema. Two of seven patients who developed chronic thyroid disease also developed chronic liver disease. Among the 20 patients with thyroid disease were 18 females.”

[crowchez]

Thanks for posting this Andrea. I have Hashimoto’s, AS & am HLA B27+. I will definitely be adding this testing on my next bloodwork. I was originally on doxy, then a doxy/mino combo, now all mino. Makes me wonder if I should be back on doxy. I would love to get the thyroid stuff under control & off the supps. Mmmm….

I’ll be interested to see what Dr. F suggests for you.

[Margaret Mueller]

How is Dr. F treating the Yerinia Entercolitica?

[Author]

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