The Immune Reconstitution Inflammatory Syndrome in Whipple Disease

Feurle, Gerhard E.; Moos, Verena; Schinnerling, Katina; Geelhaar, Anika; Allers, Kristina; Biagi, Federico; Bläker, Hendrik; Moter, Annette; Loddenkemper, Christoph; Jansen, Andreas; Schneider, Thomas

doi:10.7326/0003-4819-153-11-201012070-00004

Cited by 112 publications

(106 citation statements)

References 24 publications

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“…IRIS is a serious complication during antimicrobial treatment observed in approximately 10% of patients with classic Whipple's disease (218,220). A study done by Moos and colleagues concluded that T. whipplei must have an immunosuppressive effect on CD4 ϩ T cells because of the frequent emergence of IRIS after antibiotic treatment of Whipple's disease (220).…”

Section: Other Treatment Considerationsmentioning

confidence: 99%

“…Biological treatment with TNF-␣ inhibitors has been shown to be fatal due to exacerbation with a mean time of 26 months after the start of treatment (107,217). Previous immunosuppressive treatment is a major risk factor for the development of immune reconstitution inflammatory syndrome (IRIS) in classic Whipple's disease (218,219).…”

Section: Other Treatment Considerationsmentioning

confidence: 99%

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Clinical Manifestations, Treatment, and Diagnosis of Tropheryma whipplei Infections

et al. 2017

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SUMMARY Whipple's disease is a rare infectious disease that can be fatal if left untreated. The disease is caused by infection with Tropheryma whipplei, a bacterium that may be more common than was initially assumed. Most patients present with nonspecific symptoms, and as routine cultivation of the bacterium is not feasible, it is difficult to diagnose this infection. On the other hand, due to the generic symptoms, infection with this bacterium is actually quite often in the differential diagnosis. The gold standard for diagnosis used to be periodic acid-Schiff (PAS) staining of duodenal biopsy specimens, but PAS staining has a poor specificity and sensitivity. The development of molecular techniques has resulted in more convenient methods for detecting T. whipplei infections, and this has greatly improved the diagnosis of this often missed infection. In addition, the molecular detection of T. whipplei has resulted in an increase in knowledge about its pathogenicity, and this review gives an overview of the new insights in epidemiology, pathogenesis, clinical manifestations, diagnosis, and treatment of Tropheryma whipplei infections.

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Section: Other Treatment Considerationsmentioning

confidence: 99%

Section: Other Treatment Considerationsmentioning

confidence: 99%

Clinical Manifestations, Treatment, and Diagnosis of Tropheryma whipplei Infections

et al. 2017

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“…This had been labeled IRIS or the "immune reconstitution inflammatory syndrome" and may respond to corticosteroids, rather than antimicrobials. Rarely, this unusual syndrome has been reported to be complicated by small intestinal perforation [36] . Other bacterial agents, including tuberculosis, have become increasingly recognized as a cause, especially with rising incidence of human immunodeficiency virus (HIV) [37] .…”

Section: Other Infectionsmentioning

confidence: 99%

Spontaneous free perforation of the small intestine in adults

Freeman¹

2014

WJG

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“…The most characteristic clinical variant is palindromic rheumatism [1,2]. There is often an inverse correlation between intestinal and articular symptoms in this disease [3].…”

Section: Introductionmentioning

confidence: 99%

Scintigraphic History of Arthritis in Whipple’s Disease

Eg¹,

Dt²,

Ev³

2017

IJRRT

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The article describes a 4-year clinical observation of a 56-year-old male with Whipple's disease. The diagnosis was established based on the progressive diarrhea with malabsorbtion, detection by CT a low-density retroperitoneal infiltrate and mesenterial lymphadenopathy, abundant PAS-positive macrophages in the biopsy specimens of the small intestine and mesenterial lymph nodes. Arthropathy had started 10 years before the appearance of intestinal symptoms, regressed with its development and resumed when clinical remission was achieved.Keywords: Whipple's disease; Arthritis; Retroperitoneal lymphadenopathy; Osteoscintigraphy; Tc-99m; Sodium pyrophosphate; Accumulation coefficient Citation: Prokhorov EG, Dicheva DT, Zhilyaev EV (2017) Scintigraphic History of Arthritis in Whipple's Disease. Int J Radiol Radiat Ther 3(6): 00078.

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The Immune Reconstitution Inflammatory Syndrome in Whipple Disease

Abstract: European Commission and Deutsche Forschungsgemeinschaft.

Cited by 112 publications

References 24 publications

Clinical Manifestations, Treatment, and Diagnosis of Tropheryma whipplei Infections

Clinical Manifestations, Treatment, and Diagnosis of Tropheryma whipplei Infections

Spontaneous free perforation of the small intestine in adults

Scintigraphic History of Arthritis in Whipple’s Disease

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