Whipple's disease with axial and peripheral joint destruction

Scheib, J. S. and Quinet, R. J. (1990) Whipple's disease with axial and peripheral joint destruction. Southern Medical Journal, 83 6: 684-687. doi:10.1097/00007611-199006000-00024


Author Scheib, J. S.
Quinet, R. J.
Title Whipple's disease with axial and peripheral joint destruction
Journal name Southern Medical Journal   Check publisher's open access policy
ISSN 0038-4348
1541-8243
Publication date 1990-06
Sub-type Article (original research)
DOI 10.1097/00007611-199006000-00024
Volume 83
Issue 6
Start page 684
End page 687
Total pages 4
Place of publication Philadelphia, PA, United States
Publisher Lippincott Williams & Wilkins
Language eng
Abstract A seropositive white man had follow-up for 16 years with a diagnosis of palindromic rheumatism. Treatment had included parenteral gold, methotrexate, prednisone, hydroxychloroquine sulfate, and penicillamine before diarrhea led to a biopsy-proven diagnosis of Whipple's disease. Clinical and radiographic criteria for ankylosing spondylitis were met. In addition to classic Whipple's arthropathy, he had the combined but singular findings of pancarpal destruction and cervical apophyseal fusion. HLA typing revealed the B7 antigen. This case illustrates the pitfalls in diagnosis of a chronic polyarthritis that has, as a typical feature, a long latency before manifesting its more specific signs and symptoms (ie, diarrhea, malabsorption, and hyperpigmentation). Care should be taken during evaluation of any disease with atypical and nonspecific features (eg, positive rheumatoid factor in a patient with polyarthritis) and one should continue to reevaluate the original impression, while confirmatory evidence is lacking. Moreover, the roentgenographic findings of pancarpal narrowing, apophyseal fusion, and advanced iliofemoral joint disease, in addition to sacroiliitis and syndesmophyte formation, challenge the generally held notion that Whipple's arthropathy is a nondestructive joint disease.
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Unknown

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
 
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Created: Mon, 14 Mar 2011, 09:58:54 EST