Seronegative Arthritis as a Complication of Whipple’s Disease

DeBoer, Rebecca; Jayatilaka, Sahani; Donato, Anthony A.

doi:10.1177/11795476211017717

Cited by 3 publications

(1 citation statement)

References 10 publications

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“…Проводить исследование синовиальной жидкости при артроскопии для выявления TW при помощи ПЦР, однако могут быть серонегативные формы заболевания. При несвоевременной диагностике происходит прогрессирование БУ с развитием хронического септического деструктивного полиартрита [11]. В 2019 г. сообщено о первом случае БУ у 62-летнего северо-африканца в сочетании с эрозивном ревматоидным артритом, двусторонним эндопротезированием тазобедренных суставов на фоне терапии метотрексатом и адалимумабом [12].…”

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Whipple’s disease: 5-year clinical follow-up

Kupriyanova,

Berdnikov,

Bozrov

et al. 2024

ECG

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The article presents a clinical observation of Whipple’s disease in a 42-year-old patient with a history of stage IIB Hodgkin’s lymphoma, in whom the disease debuted with articular syndrome, lymphadenopathy of the retroperitoneal and mesenteric lymph nodes, deep vein thrombosis of the leg. The diagnosis was confirmed by a morphological study of biopsy specimens of the duodenal mucosa, mesenteric lymph nodes 12 p. of the intestine, electron microscopic detection of accumulations of rod-shaped bacteria in the intestinal mucosa 6 years after the onset of clinical manifestations. Dynamic observation for 5 years was carried out using video gastroduodenoscopy, morphological assessment of changes in xanthoma macrophages proposed by A. Herbay, the percentage of damage by PAS-positive macrophages to the area of the lamina propria of the duodenal mucosa of the intestine. Conducted therapy with ceftriaxone for 14 days followed by taking co-trimaxosole for 4 years 7 months led to a stable remission.

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Section: Discussionunclassified

Whipple’s disease: 5-year clinical follow-up

Kupriyanova,

Berdnikov,

Bozrov

et al. 2024

ECG

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2022

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Whipple’s Disease Endocarditis Following Immunomodulatory Treatment for Arthritis: A Case Report and Screening Recommendation

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Meade,

Arif

et al. 2024

Cureus

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Whipple's disease (WD) is a rare systemic disorder affecting various organ systems, including the gastrointestinal, cardiovascular, and joint systems. This report discusses a case of WD endocarditis likely associated with tocilizumab (TCZ), an immunomodulator used to treat refractory seronegative arthritis, in a patient with coronary artery disease and rheumatoid arthritis. The diagnosis was confirmed through laboratory studies, imaging, and esophagogastroduodenoscopy with biopsies. WD is increasingly recognized as a potential etiology of seronegative arthritis, with joint pain often preceding gastrointestinal symptoms. Immunomodulatory agents such as TCZ, while effective for rheumatoid arthritis, may exacerbate underlying WD, potentially leading to severe complications such as endocarditis. This case reveals the importance of considering WD in patients with refractory arthritis and the necessity of thorough diagnostic evaluation before initiating immunomodulatory therapy. Epidemiological studies indicate a higher prevalence of WD in certain demographics, highlighting the need for targeted screening with noninvasive screening methodologies, such as stool and saliva polymerase chain reaction testing.

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Seronegative Arthritis as a Complication of Whipple’s Disease

Cited by 3 publications

References 10 publications

Whipple’s disease: 5-year clinical follow-up

Whipple’s disease: 5-year clinical follow-up

Prednisone

Whipple’s Disease Endocarditis Following Immunomodulatory Treatment for Arthritis: A Case Report and Screening Recommendation

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