ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2019
Potential Role for Urine Polymerase Chain Reaction in the Diagnosis of Whipple's Disease.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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9 citing papers in PubMed, 37 citations in OpenAlex.
- Whipple Disease Presenting as Isolated Transverse Myelitis with Permanent Neurological Damage in a Patient with Systemic Lupus Erythematosus: A Case Report of a Difficult Diagnosis with a Literature Review.Infectious disease reports · 2024Article
- Short-Term Amoxicillin Clavulanate in the Treatment of Pulmonary Abscess Caused byInfection and drug resistance · 2024Article
- [Chronic Tropheryma whipplei infection: an important differential diagnosis of refractory polyarthritis].Zeitschrift fur Rheumatologie · 2023Article
- Autoimmunity and Infection in Glomerular Disease.Microorganisms · 2023Review
- Direct Kidney Involvement byKidney international reports · 2023Article
- Recovery of hearing loss, depression and erosive polyarthritis after diagnosis of Whipple's disease.Rheumatology advances in practice · 2023Article
- Why Is Whipple's Disease Still a Challenging Diagnosis? A Case Report and Brief Review of Literature.Cureus · 2023Article
- A Massive Number of ExtracellularFrontiers in immunology · 2022Review
- [The rich diversity of Whipple's disease].Zeitschrift fur Rheumatologie · 2019Review
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17 authors at 7 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWhipple's disease (WD) is a rare infection with Tropheryma whipplei that is fatal if untreated. Diagnosis is challenging and currently based on invasive sampling. In a case of WD diagnosed from a kidney biopsy, we observed morphologically-intact bacteria within the glomerular capsular space and tubular lumens. This raised the questions of whether renal filtration of bacteria is common in WD and whether polymerase chain reaction (PCR) testing of urine might serve as a diagnostic test for WD.
methodsWe prospectively investigated urine samples of 12 newly-diagnosed and 31 treated WD patients by PCR. As controls, we investigated samples from 110 healthy volunteers and patients with excluded WD or acute gastroenteritis.
resultsOut of 12 urine samples from independent, therapy-naive WD patients, 9 were positive for T. whipplei PCR. In 3 patients, fluorescence in situ hybridization visualized T. whipplei in urine. All control samples were negative, including those of 11 healthy carriers with T. whipplei-positive stool samples. In our study, the detection of T. whipplei in the urine of untreated patients correlated in all cases with WD.
conclusionsT. whipplei is detectable by PCR in the urine of the majority of therapy-naive WD patients. With a low prevalence but far-reaching consequences upon diagnosis, invasive sampling for WD is mandatory and must be based on a strong suspicion. Urine testing could prevent patients from being undiagnosed for years. Urine may serve as a novel, easy-to-obtain specimen for guiding the initial diagnosis of WD, in particular in patients with extra-intestinal WD.
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