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| Content Provider | World Health Organization (WHO)-Global Index Medicus |
|---|---|
| Author | Hoppé, Emmanuel Masson, Charles Audran, Maurice Drillon, Marie Andreu, Marita Saraux, Alain Berthelot, Jean-Marie Maugars, Yves Hmamouchi, Ihsane Morel, Jacques |
| Description | Country affiliation: France Author Affiliation: Hoppé E ( Service de rhumatologie, Inserm U922, centre hospitalier universitaire d'Angers, 4, rue Larrey, 49933 Angers cedex 9, France. emhoppe@chu-angers.fr) |
| 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 TNFalpha 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. |
| File Format | HTM / HTML |
| ISSN | 1297319X |
| Issue Number | 4 |
| Volume Number | 77 |
| e-ISSN | 17787254 |
| Journal | Joint Bone Spine |
| Language | English |
| Publisher | Elsevier |
| Publisher Date | 2010-07-01 |
| Publisher Place | France |
| Access Restriction | One Nation One Subscription (ONOS) |
| Subject Keyword | Discipline Rheumatology Arthritis, Rheumatoid Drug Therapy Immunosuppressive Agents Therapeutic Use Spondylarthropathies Spondylitis, Ankylosing Tumor Necrosis Factor-alpha Antagonists & Inhibitors Whipple Disease Diagnosis Adalimumab Adult Aged Anti-bacterial Agents Antibodies, Monoclonal Adverse Effects Antibodies, Monoclonal, Humanized Doxycycline Etanercept Female Humans Hydroxychloroquine Immunoglobulin G Infliximab Male Middle Aged Receptors, Tumor Necrosis Factor Retrospective Studies Case Reports Journal Article |
| Content Type | Text |
| Resource Type | Case study Article |
| Subject | Rheumatology |
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