Maladie de Whipple : un diagnostic différentiel de polyarthrite à ne pas oublier

Article Article scientifique Article Maladie de Whipple : un diagnostic différentiel de polyarthrite à ne pas oublier fre 2016 author Andre Raphaël 631182 author Ehresmann Benjamin 585508 author Stirnemann Jérôme 793435 author Seebach Jorg Dieter 647894 704-707 27197326 1660-9379 Whipple disease is a rare and potentially fatal bacterial infection induced by a Gram-positive bacillus, Tropheryma whipplei. It is responsible for articular, digestive, neurological, ophthalmological and cardiological symptoms that occur either concomitant or isolated. Thus, the diagnosis is difficult to make and therefore often delayed. A paradoxal exacerbation of the symptoms under immunosuppressive drugs such as glucocorticoids and anti-TNF mAb, or inexpected improvements under antibiotic treatment applied for other reasons should raise a clinicial suspicion of Whipple's disease. Detection of the germ on stool and saliva samples by molecular biology methods has become straightforward with very good positive and negative predictive values. Long-term antibiotic treatment close follow-up are required for the induction of remission and to recognize relapse. Algorithms Anti-Bacterial Agents/therapeutic use Arthritis/diagnosis DNA Bacterial/genetics Diagnosis Differential Humans Polymerase Chain Reaction Whipple Disease/diagnosis/drug therapy Dewey 616 56 Département de médecine 221 false 518 Cellules NK et récepteurs FcyR dans l'auto-immunité et le rejet de xénotransplantation 856 Revue médicale suisse 12 513 91c21dab-aea7-455e-8bff-fc431b30b943 Article (Published version) Public RMS_513_704.pdf 6049526 application/pdf OA OTHER openAccess Faculté de médecine / Section de médecine clinique / Département de médecine

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Maladie de Whipple : un diagnostic différentiel de polyarthrite à ne pas oublier	Revue médicale suisse			2016	528	574

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Ehresmann, Benjamin