Healio Rheuminations

Whipple’s Disease: When Should a Rheumatologist Take a Whiff of Whipple’s?


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This episode dives into the rare Whipple’s disease, focusing on the articular manifestations of this infectious masquerader and when a rheumatologist should consider it in the differential.

Brought to you by GSK. Considering a treatment change for patients with active SLE? Learn about a treatment option for your patients at treatfortodayandtomorrow.com.

  • Intro :20
  • In this episode :28
  • Background on the organism 5:25
  • An important point when making the diagnosis 7:48
  • Who gets infected? 8:55
  • What is Whipple’s disease? 11:48
  • This disease is fatal 15:53
  • A look at the joints 16:28
  • What happens when you give these patients immunosuppression? 26:36
  • How to diagnose 28:38
  • Summary so far 31:00

Brought to you by GSK. Consider the long-term impact of disease activity, flares and corticosteroid use on patients with active SLE. Learn more now at treatfortodayandtomorrow.com

  • Other organ manifestations of Whipple’s disease 32:08
  • Summary and take-home 44:36

Disclosure: Brown reports no relevant financial disclosures.

We’d love to hear from you! Send your comments/questions to [email protected]. Follow us on Twitter @HRheuminations @AdamJBrownMD @HealioRheum

References:

Bousbia S, et al. Emerg Infect Dis. 2010;16:258-63.

Chan RY, et al. Ophthalmology. 2001;108:2225-2231.

Dobbins 3rd WO, et al. Arthritis Rheum. 1987;30:102-105.

Durand DV, et al. Medicine (Baltimore). 1997;76:170-84.

Fenollar F, et al. BMC Infect Dis. 2011;11:171.

Feurle GE, et al. Eur J Clin Invest. 1979;9:385-389.

Geissdörfer W, et al. J Clin Microbiol. 2012;50:216-22.

Guérin A, et al. Elife. 2018;7:e32340.

Heffner DK. Lancet. 2007;370:738-9; author reply 739.

Keita AK, et al. PLoS Negl Trop Dis. 2011;5:e1403.

Lagier JC, et al. Medicine (Baltimore). 2010;89:337-345.

Lozupone C, et al. Am J Respir Crit Care Med. 2013;187:1110-7.

McAllister Jr. HA, Fenoglio Jr. JJ. Circulation. 1975;52:152-6.

O’Duffy JD, et al. Arthritis Rheum. 1999;42:812-817.

Puéchal X. Joint Bone Spine. 2016;83:631-635.

Puéchal X, et al. Arthritis Rheum. 2002;46:1130-1132.

Puéchal X, et al. Arthritis Rheum. 2007;56:1713-1718.

Raheja AA, et al. Clin Imaging. 2010;34:143-147.

Ramos JM, et al. J Med Case Rep. 2015;9:165.

Raoult D, et al. Emerg Infect Dis. 2010;16:776-82.

Schöniger-Hekele M, et al. Appl Environ Microbiol. 2007;73:2033-2035.

Stein A, et al. Am J Respir Crit Care Med. 2013;188:1036-7.

Additional resource:

Neurosigns.org’s video on oculomasticatory myorhythmia can be viewed at: https://www.youtube.com/watch?v=Zwb5bt749Jo

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Healio RheuminationsBy Adam J. Brown, MD

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