Antibodies to the chlamydial 60 kd heat-shock protein are associated with laparoscopically confirmed perihepatitis.
OBJECTIVE
Our purpose was to examine clinical, microbiologic, serologic, and laparoscopic findings associated with perihepatitis.


METHODS
In a prospective study of 157 women with a clinical diagnosis of pelvic inflammatory disease, 27 women with laparoscopically confirmed perihepatitis and salpingitis were compared with 46 patients with salpingitis alone.


RESULTS
Both current use or a history of ever using oral contraceptives was negatively associated with perihepatitis (p = 0.05 and p = 0.008, respectively). Moderate-to-severe pelvic adhesions were present at laparoscopy significantly more often in the perihepatitis-salpingitis group (70%) than in the salpingitis alone group (35%, p = 0.003). Antibody to the chlamydial 60 kd heat-shock protein at > or =0.5 optical density was detected in 67% of the perihepatitis-salpingitis group and in 28% of the salpingitis alone group (p = 0.005), and the median titer was significantly higher in the former group (p = 0.02).


CONCLUSIONS
Compared with women with salpingitis alone, patients with perihepatitis-salpingitis do not have distinctive clinical or microbiologic findings but do manifest a higher prevalence of moderate-to-severe pelvic adhesions and both a higher prevalence and higher titers of antibody to the chlamydial heat-shock protein-60.
Money
D M
DM
Department of Obstetrics and Gynecology, University of Washington, Seattle 98195-6523, USA.
Hawes
S E
SE
Eschenbach
D A
DA
Peeling
R W
RW
Brunham
R
R
Wölner-Hanssen
P
P
Stamm
W E
WE
D000328:Adult; D000907:Antibodies, Bacterial / Q000097:blood*; D018834:Chaperonin 60 / Q000276:immunology*; D002690:Chlamydia Infections / Q000150:complications; D002692:Chlamydia trachomatis / Q000276:immunology* / Q000302:isolation & purification; D005260:Female; D006505:Hepatitis / Q000150:complications / Q000276:immunology* / Q000382:microbiology; D006801:Humans; D009344:Neisseria gonorrhoeae / Q000302:isolation & purification; D010388:Pelvis; D011446:Prospective Studies; D012488:Salpingitis / Q000150:complications / Q000276:immunology* / Q000382:microbiology; D018709:Statistics, Nonparametric; D000267:Tissue Adhesions
D000907:Antibodies, Bacterial; D018834:Chaperonin 60