Pathological study of Fitz-Hugh-Curtis syndrome evaluated from fallopian tube damage.
OBJECTIVE
To analyze the causative pathogen, surgical indication and fallopian tube damages in Fitz-Hugh-Curtis syndrome (FHCS) cases diagnosed by laparoscopy.


METHODS
Laparoscopic findings in 3568 cases at our hospital were reviewed retrospectively. Of these, 108 cases were diagnosed to have FHCS and examined for causative pathogens. Chlamydial infection was determined by both Chlamydia trachomatis (CT) antigens in the cervix and serum anti-CT antibodies. One hundred and four cases with chronic FHCS were divided into hydrosalpinx (H) and normal (N) groups based on the fallopian tube conditions, and were compared for patient profiles, tubal functions and perihepatic adhesion.


RESULTS
Among surgical indications, tubal infertility and ectopic pregnancy were more often associated with FHCS than any other diseases. The primary causative pathogen of FHCS was CT. In 104 cases with chronic FHCS, there was no difference in CT antigen positivity between the H and N groups. The serum anti-CT IgG titer also did not differ between the two groups, although anti-CT IgA was slightly higher in the H group. The peritubal adhesion score was significantly higher in the H group, but it was not correlated with the degree of perihepatic adhesion.


CONCLUSIONS
While some FHCS patients had severe fallopian tube dysfunctions, such as hydrosalpinx and tubal occlusion, 30% of FHCS cases did not show any abnormalities in the fallopian tube. Our study indicated that the severity of tubal dysfunctions associated with FHCS is determined by the host's reactivity to CT.
Kobayashi
Yuko
Y
Department of Obstetrics and Gynecology, Juntendo University School of Medicine, Tokyo, Japan. yuko555@abox2.so-net.ne.jp
Takeuchi
Hiroyuki
H
Kitade
Mari
M
Kikuchi
Iwaho
I
Sato
Yuichi
Y
Kinoshita
Katsuyuki
K
D000328:Adult; D002690:Chlamydia Infections / Q000382:microbiology / Q000473:pathology* / Q000601:surgery; D002692:Chlamydia trachomatis / Q000254:growth & development*; D005184:Fallopian Tube Diseases / Q000382:microbiology / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D000292:Pelvic Inflammatory Disease / Q000382:microbiology / Q000473:pathology* / Q000601:surgery; D012189:Retrospective Studies