Whipple’s disease diagnosed during biological treatment for joint disease - 12/07/10
, Charles Masson a, Maurice Audran a, Marie Drillon b, Marita Andreu b, Alain Saraux c, Jean-Marie Berthelot d, Yves Maugars d, Ihsane Hmamouchi e, Jacques Morel e
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Abstract |
Objectives |
Increased susceptibility to infections is among the main safety concerns raised by biological agents. We describe five cases of Whipple’s disease diagnosed during treatment with biological agents.
Methods |
We retrospectively identified five cases of Whipple’s disease diagnosed between 2003 and 2009 in patients treated with TNF⍺ antagonists in five French hospitals.
Results |
Five patients (four male; mean age: 50.4 years; range: 38–67) underwent biological therapy according to prior diagnoses of rheumatoid arthritis (n=2), ankylosing spondylitis (n=2), or spondyloarthropathy (n=1). Biological therapy failed to control the disease, which responded to appropriate antibiotics for Whipple’s disease. Retrospectively, clinical symptoms before biological therapy were consistent with Whipple’s disease. All five patients had favorable outcomes (mean follow-up, 29 months [13–71]).
Conclusions |
Biological therapy probably worsened preexisting Whipple’s disease, triggering the visceral disorders. Whipple’s disease must be ruled out in patients with joint disease, as patients with this spontaneously fatal condition should not receive immunosuppressive agents.
Le texte complet de cet article est disponible en PDF.Keywords : Whipple’s disease, Tropheryma whippleii, Anti-TNF⍺ drugs, Rituximab, Abatacept
Plan
 | The final manuscript has been seen and approved by all the authors and they have given necessary attention to ensure the integrity of the work. |
Vol 77 - N° 4
P. 335-339 - juillet 2010 Retour au numéro
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