AI Article Synopsis
- Refractory arthritis often poses diagnostic challenges, and chronic Tropheryma whipplei infection should be a key consideration in these cases.
- This case-based review examines five clinical instances of Whipple's disease, highlighting its symptoms, which include joint pain, weight loss, and diarrhea, sometimes occurring in isolation from gastrointestinal issues.
- The need for proper diagnosis is emphasized, as T. whipplei infections can be mistaken for autoimmune arthritis, with specific testing, like polymerase chain reaction analysis of synovial fluid, being crucial for accurate detection.
Article Abstract
Background: Refractory arthritis is a common problem in routine rheumatology practice, and can be a diagnostic challenge. In these cases, chronic Tropheryma whipplei (T. whipplei) infection is an important differential diagnosis that should be considered.
Objective: Based on five clinical cases, this case-based review describes the diagnostic and therapeutic principles in the management of chronic T. whipplei infection.
Results: Whipple's disease is a multisystemic infectious disease caused by the bacterium T. whipplei. The disease typically manifests with arthralgia, weight loss and diarrhoea. Joint involvement often develops years before gastrointestinal symptoms occur. In addition to systemic manifestations ("classic Whipple's disease"), T. whipplei can also lead to localized joint infections without gastrointestinal involvement. Articular manifestations of systemic and localized T. whipplei infections are commonly misdiagnosed as a sign of various forms of autoimmmune arthritis.
Discussion: Whipple's disease and localized T. whipplei joint infection should be considered in the diagnostic work-up of refractory arthritis. Synovial fluid analysis by means of specific polymerase chain reaction-based testing for T. whipplei is diagnostically ground-breaking.
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|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10695860 | PMC |
| http://dx.doi.org/10.1007/s00393-022-01194-5 | DOI Listing |
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