scholarly journals Whipple disease - systemic disease with gastrointestinal manifestations

2021 ◽  
Vol 67 (5) ◽  
pp. e03-e08
Author(s):  
Leoš Chrudimský
Keyword(s):  
Systemic Disease ◽  
Gastrointestinal Manifestations ◽  
Whipple Disease

scholarly journals Rheumatological features of Whipple disease

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Alice Tison ◽  
Pauline Preuss ◽  
Clémentine Leleu ◽  
François Robin ◽  
Adrien Le Pluart ◽  
...  
Keyword(s):  
Small Bowel ◽  
Systemic Disease ◽  
Periodic Acid ◽  
Tnf Inhibitors ◽  
Biopsy Sample ◽  
National Study ◽  
Periodic Acid Schiff ◽  
Small Bowel Biopsy ◽  
Whipple Disease ◽  
Pas Staining

AbstractWhipple disease (WD) is a rare infectious systemic disease. Rheumatologists are at the frontline of WD diagnosis due to the early rheumatological manifestations. An early diagnosis is crucial, as usual anti-rheumatic drugs, especially TNF inhibitors, may worsen the disease course. We conducted a retrospective multicentre national study from January 2010 to April 2020 to better characterize the rheumatological features of WD. Classic WD (CWD) was defined by positive periodic acid-Schiff (PAS) staining of a small-bowel biopsy sample, and non-CWD (NCWD) was defined by negative PAS staining of a small-bowel biopsy sample but at least one positive Tropheryma whipplei (TW) polymerase chain reaction (PCR) for a digestive or extradigestive specimen. Sixty-eight patients were enrolled, including 11 CWD patients. Twenty patients (30%) received TNF inhibitors during the WD course, with inefficacy or symptom worsening. More digestive symptoms and systemic biological features were observed in CWD patients than in NCWD patients, but both patient groups had similar outcomes, especially concerning the response to antibiotics and relapse rate. Stool and saliva TW PCR sensitivity were both 100% for CWD and 75% for NCWD and 89% and 60% for small-bowel biopsy sample PCR, respectively. WD encountered in rheumatology units has many presentations, which might result from different pathophysiologies that are dependent on host immunity. Given the heterogeneous presentations and the presence of chronic carriage, multiple TW PCR tests on samples from specific rheumatological sites when possible should be performed, but samples from nonspecific digestive and extradigestive sites also have great value.

Gastrointestinal manifestations of systemic disease: a multimodality review

2014 ◽  
Vol 40 (6) ◽  
pp. 1926-1943 ◽  
Author(s):  
John Nay ◽  
Christine O. Menias ◽  
Vincent M. Mellnick ◽  
Dennis M. Balfe
Keyword(s):  
Systemic Disease ◽  
Gastrointestinal Manifestations

Recurrent Acute Hyperparathyroidism with Severe Gastrointestinal Manifestations

1960 ◽  
Vol 39 (1) ◽  
pp. 83-89 ◽  
Author(s):  
Abraham Atsmon ◽  
Menachem Frank ◽  
Paul Nathan ◽  
Andre de Vries
Keyword(s):  
Gastrointestinal Manifestations ◽  
Acute Hyperparathyroidism
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