ByAdam J. Brown, MD

May 20, 2020

47 min listen

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

ByAdam J. Brown, MD

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

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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 rheuminationspodcast@healio.com. Follow us on Twitter @HRheuminations @AdamJBrownMD @HealioRheum

References:

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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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Sources/Disclosures

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Disclosures: Brown reports no relevant financial disclosures.

Read more about

whipple’s disease

immunosuppression