Seronegative Arthritis and Whipple Disease: Risk of Misdiagnosis in the Era of Biologic Agents
Joint Authors
Pizzolitto, Stefano
Quartuccio, Luca
Giovannini, Ivan
Scarpa, Maurizio
De Vita, Salvatore
Source
Issue
Vol. 2019, Issue 2019 (31 Dec. 2019), pp.1-6, 6 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2019-10-13
Country of Publication
Egypt
No. of Pages
6
Main Subjects
Abstract EN
We report 2 cases of Whipple disease (WD), previously diagnosed as seronegative polyarthritis and treated for several years with immunosuppressive agents, accordingly.
Both cases had been treated over years with cDMARDs and bDMARDs.
The first patient was a 48-year-old male, who developed a life-threatening disease characterized by fever, significant weight loss, and bloody diarrhoea, supported with RBC transfusions.
The second patient was a 55-year-old man, presenting with arthritis, fever, serositis, lymphadenopathy, thoracic rash, and systemic inflammation; at the beginning he was diagnosed as adult onset Still’s disease.
He was treated with steroids and antitumour necrosis factor agents, but showed no improvement.
Both patients were eventually treated with antimicrobial therapy for WD with dramatic improvement and no clinical relapse in 6 months.
This paper reviews the literature on WD mimicking chronic inflammatory arthritis.
WD may lead to chronic seronegative arthritis that might often be misrecognized.
Importantly, patients treated with bDMARDs and glucocorticoids might develop a life-threatening disease.
Therefore, WD should be suspected and excluded in patients showing resistance or frequent recurrence of chronic arthritis, if seronegative, under treatment with bDMARDs, especially in the presence of new, unexpected sign and/or symptoms.
American Psychological Association (APA)
Quartuccio, Luca& Giovannini, Ivan& Pizzolitto, Stefano& Scarpa, Maurizio& De Vita, Salvatore. 2019. Seronegative Arthritis and Whipple Disease: Risk of Misdiagnosis in the Era of Biologic Agents. Case Reports in Rheumatology،Vol. 2019, no. 2019, pp.1-6.
https://search.emarefa.net/detail/BIM-1144213
Modern Language Association (MLA)
Quartuccio, Luca…[et al.]. Seronegative Arthritis and Whipple Disease: Risk of Misdiagnosis in the Era of Biologic Agents. Case Reports in Rheumatology No. 2019 (2019), pp.1-6.
https://search.emarefa.net/detail/BIM-1144213
American Medical Association (AMA)
Quartuccio, Luca& Giovannini, Ivan& Pizzolitto, Stefano& Scarpa, Maurizio& De Vita, Salvatore. Seronegative Arthritis and Whipple Disease: Risk of Misdiagnosis in the Era of Biologic Agents. Case Reports in Rheumatology. 2019. Vol. 2019, no. 2019, pp.1-6.
https://search.emarefa.net/detail/BIM-1144213
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1144213