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Article Dans Une Revue Joint Bone Spine Année : 2010

Whipple's disease diagnosed during biological treatment for joint disease

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1
Emmanuel Hoppé
  • Fonction : Auteur
Marie Drillon
  • Fonction : Auteur
Marita Andreu
  • Fonction : Auteur
Alain Saraux
Jean-Marie Berthelot
  • Fonction : Auteur
Yves Maugars
  • Fonction : Auteur
  • PersonId : 906859
Ihsane Hmamouchi
  • Fonction : Auteur
Jacques Morel

Résumé

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 TNFα 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.

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Dates et versions

hal-03350072 , version 1 (21-09-2021)

Identifiants

Citer

Emmanuel Hoppé, Charles Masson, Maurice Audran, Marie Drillon, Marita Andreu, et al.. Whipple's disease diagnosed during biological treatment for joint disease. Joint Bone Spine, 2010, 77 (4), pp.335-339. ⟨10.1016/j.jbspin.2010.03.015⟩. ⟨hal-03350072⟩

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