During the period 1974-1983, Yersinia enterocolitica infection was diagnosed in 458 hospitalized patients by antibody response or isolation of the micro-organism. A total of 54 (11.9%) patients had acute liver infection, with significantly elevated serum levels (greater than or equal to 2-fold) of bilirubin and/or enzyme levels. Serious liver disease with cellular necrosis was observed in biopsy specimens from two of 12 patients examined; six had unspecific changes. The patients were followed up for 4-14 years (until 1987). A total of 22 (4.9%) patients were readmitted with chronic liver disease; in one case non-specific microscopic changes developed into granulomatous hepatitis over a period of 3 years. In both the acute and chronic stages of disease, liver involvement was associated with involvement of other organ systems, and some patients developed multi-organ disease. Chronic liver disease was associated with positive tests for antinuclear antibody and rheumatoid factor, and with a high mortality.
During the period 1974-1983, Yersinia enterocolitica infection was diagnosed in 458 hospitalized patients by antibody response or isolation of the micro-organism. Eight (1.75%) patients showed signs of acute pancreatitis with elevated serum or urine levels of amylase; two patients had acute insulin-dependent diabetes. The patients were followed up for 4-14 years (until 1987). Four patients were readmitted with chronic pancreatitis, and one with acute pancreatitis. Diabetes developed in two males and nine females; in seven cases this was associated with chronic conditions of possible autoimmune aetiology. In 1987 a significantly higher than expected prevalence of diabetes was demonstrated among female subjects aged 30-54 years. Yersinia enterocolitica infection constitutes a differential diagnosis in acute pancreatitis, and might be related to the development of chronic pancreatitis and diabetes.
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