The analysis of anti-Chlamydia trachomatis antibody in relation to adnexal adhesion.
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概要
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Chlamydia trachomatis recently emerged as the most common causative organism among the sexually transmitted diseases. We studied the clinical usefulness of the quantitative analysis of antiChlamydia trachomatis antibodies (IgA and IgG) among 95 patients (35; infertility, 26; ectopic pregnancy, 25; ovarian cyst, 3; genital anomaly, 3; second look surgery for ovarian cancer, 2; ovarian bleeding, 1; varicocele of the ovary) who underwent laparoscopic pelvic examination or operation in Kobe University Hospital in past two years. Serum levels of the antibodies were measured by ELISA. The patients were divided into three groups ((-)group, (+)group, and (++)group) depending on the titer of the antibodies. The IgG and/or IgA antibody positive rate in the patients with infertility was 42.9%, and was 57.7%in the patients with ectopic pregnancy. These positive rates were significantly higher than those in the patients with benign ovarian cysts (12.0%). The patients who were the positive for Chlamydia trachomatis antibodies showed higher frequency of adnexal adhesions (88.9%) than those who had negative results (23.8%). The mean adhesion score (American Fertility Society classification) of IgA (++)group was not higher than that of IgA (+)group, although that of IgA (+)group was significantly Niger than that of IgA (-)group. On the other hand, the mean adhesion score of IgG (++)group was higher than IgG (+)group and was significantly higer than IgG (-)group. In order to establish the diagnosis of Chlamydia trachomatis infection, the determination of the serum levels of the antibodies has clinical importance to understand previous and current infection, although the detection of antigen is also important to determine the current infection. Quantitative analysis of the antibodies, especially IgG antibody, may provide relevant clinical information in the screening of possible formation of adnexal adhesion. [Adv. Obstet. Gynecol., 52 (6): 766-770, 2000(H.12.11)]
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