ArticleScientific reports2021
Differential diagnostic value of rheumatic symptoms in patients with Whipple's disease.
Article in Scientific reports, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 15 citations in OpenAlex.
- Prevalence, characteristics, and clinical outcomes of Whipple disease in patients initially diagnosed with a rheumatic disease: a large nested case-control study in the Eastern Netherlands.EULAR rheumatology open · 2026Article
- Whipple's disease with multiple serous effusions as the clinical manifestation: a case report and literature review.Infectious diseases of poverty · 2026Review
- Deciphering whipple's disease complexity.Clinical and experimental medicine · 2026Review
- [Chronic Tropheryma whipplei infection: an important differential diagnosis of refractory polyarthritis].Zeitschrift fur Rheumatologie · 2023Article
- Current knowledge of the immune reconstitution inflammatory syndrome in Whipple disease: a review.Frontiers in immunology · 2023Review
- Whipple's disease unmasked by TNF inhibitor therapy for treatment of seronegative rheumatoid arthritis.BMJ case reports · 2022Article
- Clinical manifestations of Whipple's disease mimicking rheumatic disorders.Reumatologia · 2021Review
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Most patients with Whipple's disease have rheumatic symptoms. The aim of our prospective, questionnaire-based, non-interventional clinical study was to assess whether these symptoms are useful in guiding the differential diagnosis to the rheumatic disorders. Forty patients with Whipple's disease, followed by 20 patients for validation and 30 patients with rheumatoid-, 21 with psoriatic-, 15 with palindromic- and 25 with axial spondyloarthritis were recruited for the present investigation. Patients with Whipple's disease and patients with rheumatic disorders were asked to record rheumatic symptoms on pseudonymized questionnaires. The data obtained were subjected to multiple logistic regression analysis. Episodic pain with rapid onset, springing from joint to joint was most common in patients with palindromic arthritis and second most common and somewhat less conspicuous in Whipple's disease. Continuous pain in the same joints predominated in patients with rheumatoid-, psoriatic-, and axial spondyloarthritis. Multiple logistic equations resulted in a predicted probability for the diagnosis of Whipple's disease of 43.4 ± 0.19% (M ± SD) versus a significantly lower probability of 23.8 ± 0.19% (M ± SD) in the aggregate of patients with rheumatic disorders. Mean area under the curve (AUC) ± SD was 0.781 ± 0.044, 95% CI 0.695-0.867, asymptotic significance p < 0.001. The logistic equations predicted probability for the diagnosis of Whipple's disease in the initial series of 40 patients of 43.4 ± 0.19% was not significantly different in the subsequent 20 patients of 38.2 ± 0.28% (M ± SD) (p = 0.376). The data may be useful in a predictive algorithm for diagnosing Whipple's disease. The project is registered as clinical study DRK S0001566.
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