Whipple’s disease diagnosed during anti-tumor necrosis factor alpha treatment: two case reports and review of the literature

Journal of Medical Case Reports

Rosario Sanchez-Martínez¹  Ana Gutiérrez⁴  José Rosas²  Agustín Martinez⁵  Angela Navarro⁶  Beatriz Valero¹  Nora Galipienso⁶  Francisco Pasquau⁶  Jose M. Ramos³ 

[1] Department of Internal Medicine, Hospital General Universitario de Alicante, c/ Pintor Baeza, 12, Alicante, 03010, Spain;Department of Rheumatology, Hospital Marina Baixa, Avenida Alcalde Jaume Botella Mayor, 7, Villajoyosa 03570, Alicante, Spain;Servicio de Medicina Interna, Hospital General Universitario de Alicante, c/ Pintor Baeza, 12, Alicante, 03010, Spain;Department of Gastroenterology, Hospital General Universitario de Alicante, c/ Pintor Baeza, 12, Alicante, 03010, Spain;Department of Rheumatology, Hospital General Universitario de Alicante, c/ Pintor Baeza, 12, Alicante, 03010, Spain;Department of Internal Medicine, Hospital Marina Baixa, Avenida Alcalde Jaume Botella Mayor, 7, Villajoyosa 03570, Alicante, Spain

关键词: Rheumatoid arthritis;    Spondylarthritis;    Etanercept;    Infliximab;    Whipple disease;   

Others  :  1231409
DOI  :  10.1186/s13256-015-0632-6

 received in 2015-01-07, accepted in 2015-06-03,  发布年份 2015

【 摘 要 】

Introduction

Whipple’s disease is a rare infectious disease caused by Tropheryma whipplei with protean clinical manifestations. This infection may mimic chronic inflammatory rheumatisms.

Case presentation

We report two cases of Whipple’s disease diagnosed in the context of an inflammatory disease with anti-tumor necrosis factor alpha failure. The first patient was a 58-year-old white man with psoriatic spondylarthritis, who was treated with adalimumab, etanercept, infliximab, tocilizumab and golimumab. The second was a 73-year-old white man with rheumatoid arthritis, who received treatment with infliximab, then etanercept and rituximab.

Conclusions

Whipple’s disease should be suspected in all patients diagnosed with chronic inflammatory rheumatism, partially controlled or not controlled by treatment with tumor necrosis factor alpha blockers, whose condition worsens after treatment.

【 授权许可】

   
2015 Ramos et al.

【 图 表 】

Fig. 1.

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