[Chronic Tropheryma whipplei infection: an important differential diagnosis of refractory polyarthritis].

IF 1.8 3区 生物学 Q1 ORNITHOLOGY
Ibis Pub Date : 2023-12-01 Epub Date: 2022-04-06 DOI:10.1007/s00393-022-01194-5
Nikolas Ruffer, Marie-Therese Holzer, Yannik Gkanatsas, Izabela Schinglerová, Damir Boro, Martin Krusche, Ina Kötter
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引用次数: 2

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.

慢性乳头状瘤感染:难治性多发性关节炎的重要鉴别诊断。
背景:难治性关节炎是常规风湿病实践中的常见问题,并且可能是一个诊断挑战。在这些病例中,慢性惠氏湿疣感染是一个重要的鉴别诊断,应予以考虑。目的:通过对5例临床病例的分析,阐述慢性惠氏弓形虫感染的诊断和治疗原则。结果:惠普氏病是由惠普氏杆菌引起的多系统感染性疾病。这种疾病的典型症状是关节痛、体重减轻和腹泻。关节受累通常在胃肠道症状出现前几年就已发生。除了全身性表现(“典型的惠普尔病”)外,惠普尔T.还可导致局部关节感染,而不累及胃肠道。全身和局部惠氏弓形虫感染的关节表现通常被误诊为各种形式的自身免疫性关节炎的征兆。讨论:在难治性关节炎的诊断检查中应考虑惠普氏病和局限性惠普氏关节感染。滑液分析的手段,特定的聚合酶链反应为基础的测试,为惠氏绦虫是诊断突破性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Ibis
Ibis 生物-鸟类学
CiteScore
4.60
自引率
9.50%
发文量
118
审稿时长
6-12 weeks
期刊介绍: IBIS publishes original papers, reviews, short communications and forum articles reflecting the forefront of international research activity in ornithological science, with special emphasis on the behaviour, ecology, evolution and conservation of birds. IBIS aims to publish as rapidly as is consistent with the requirements of peer-review and normal publishing constraints.
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