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Article dans une revue

Whipple's disease diagnosed during biological treatment for joint disease

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 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.

Type de document :
Article dans une revue
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https://hal.univ-angers.fr/hal-03350072
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Soumis le : mardi 21 septembre 2021 - 10:07:24
Dernière modification le : mercredi 19 janvier 2022 - 16:26:02

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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, Elsevier Masson, 2010, 77 (4), pp.335-339. ⟨10.1016/j.jbspin.2010.03.015⟩. ⟨hal-03350072⟩

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