ArticleEULAR rheumatology open2026
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.
Article in EULAR rheumatology open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Objectives: Whipple disease (WD) is a rare infectious disease with an estimated prevalence of 10 per million. As many patients with WD experience arthralgia or arthritis, they are often initially misdiagnosed with an inflammatory rheumatic disease (IRD). This study assesses the prevalence and determinants of new WD diagnoses in patients with IRD. Methods: A nested case-control study (Sint Maartenkliniek, East Netherlands) was conducted between 2012 and 2024, by comparing all WD cases initially diagnosed with IRD with a non-WD control group matched for duration of follow-up. Potential indicators (at presentation and during IRD follow-up) for WD were analysed using conditional logistic regression, and outcomes after treatment were assessed. Results: In 25,380 patients, the prevalence of WD was 1000 per million (25 cases). Male sex (odds ratio [OR], 16.3; 95% CI, 3.44-77.0), weight loss (OR, 44.7; 95% CI, 10.3-2081), polyarthritis (OR, 6.08; 95% CI, 1.64-22.5), symmetrical arthritis (OR, 11.7; 95% CI, 2.52-54.8), both small and large joint arthritis (OR, 13.6; 95% CI, 2.14-86.0), elevated C-reactive protein (OR, 10.4; 95% CI, 1.49-73.3), and testing negative for rheumatoid factor and anticyclic citrullinated peptide (OR, 23.5; 95% CI, 2.02-273) were associated with having WD. After antibiotic treatment, 88% of WD cases achieved disease-modifying antirheumatic drug-free remission. Conclusions: The prevalence of WD was about 100-fold higher in patients with IRD than in the general population. WD cases are characterised by a specific profile of strongly associated characteristics at presentation, which can contribute to earlier diagnosis and treatment of WD. The excellent outcomes after WD treatment emphasise the initial misdiagnosis of IRD rather than comorbid infection.
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.