Joint bone spine · 2010
Whipple's disease diagnosed during biological treatment for joint disease.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Ошибки и ограничения
История · было → стало
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Hoppé Emmanuel, Masson Charles, Audran Maurice, Drillon Marie, Andreu Marita, Saraux Alain, Berthelot Jean-Marie, Maugars Yves, Hmamouchi Ihsane, Morel Jacques
Аннотация
OBJECTIVES: Increased susceptibility to infections is among the main safety concerns raised by biological agents. We describe five cases of Whipple's disease diagnosed during treatment with biological agents.
METHODS: We retrospectively identified five cases of Whipple's disease diagnosed between 2003 and 2009 in patients treated with TNFalpha antagonists in five French hospitals.
RESULTS: Five patients (four male; mean age: 50.4 years; range: 38-67) underwent biological therapy according to prior diagnoses of rheumatoid arthritis (n=2), ankylosing spondylitis (n=2), or spondyloarthropathy (n=1). Biological therapy failed to control the disease, which responded to appropriate antibiotics for Whipple's disease. Retrospectively, clinical symptoms before biological therapy were consistent with Whipple's disease. All five patients had favorable outcomes (mean follow-up, 29 months [13-71]).
CONCLUSIONS: Biological therapy probably worsened preexisting Whipple's disease, triggering the visceral disorders. Whipple's disease must be ruled out in patients with joint disease, as patients with this spontaneously fatal condition should not receive immunosuppressive agents.
METHODS: We retrospectively identified five cases of Whipple's disease diagnosed between 2003 and 2009 in patients treated with TNFalpha antagonists in five French hospitals.
RESULTS: Five patients (four male; mean age: 50.4 years; range: 38-67) underwent biological therapy according to prior diagnoses of rheumatoid arthritis (n=2), ankylosing spondylitis (n=2), or spondyloarthropathy (n=1). Biological therapy failed to control the disease, which responded to appropriate antibiotics for Whipple's disease. Retrospectively, clinical symptoms before biological therapy were consistent with Whipple's disease. All five patients had favorable outcomes (mean follow-up, 29 months [13-71]).
CONCLUSIONS: Biological therapy probably worsened preexisting Whipple's disease, triggering the visceral disorders. Whipple's disease must be ruled out in patients with joint disease, as patients with this spontaneously fatal condition should not receive immunosuppressive agents.
Предметные рубрики MeSH
AdalimumabAdultAgedAnti-Bacterial AgentsAntibodies, MonoclonalAntibodies, Monoclonal, HumanizedArthritis, RheumatoidDoxycyclineEtanerceptFemaleHumansHydroxychloroquineImmunoglobulin GImmunosuppressive AgentsInfliximabMaleMiddle AgedReceptors, Tumor Necrosis FactorRetrospective StudiesSpondylarthropathiesSpondylitis, AnkylosingTumor Necrosis Factor-alphaWhipple Disease