Whipple’s disease-associated infective endocarditis: a systematic review

Ioannou, Petros; Kourtidis, Marios; Mytilinis, Dimitrios-Orestis; Psyllaki, Anna; Baliou, Stella; Kofteridis, Diamantis

doi:10.1080/23744235.2023.2214610

Cited by 3 publications

(2 citation statements)

References 109 publications

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“…Whipple’s disease is a rare systemic infection caused by T. whipplei , most frequently observed in patients with diabetes, chronic kidney disease, liver disease, and immunodeficiency[ 11 , 12 ]. Its Pathogenesis of Whipple’s disease is shown in Figure 1 .…”

Section: Discussionmentioning

confidence: 99%

Diagnosis and treatment of Whipple disease after kidney transplantation: A case report

Chen,

Niu,

Zhang

2023

World J Clin Cases

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Insulin, a small protein with 51 amino acids synthesized by pancreatic β-cells, is crucial to sustain glucose homeostasis at biochemical and molecular levels. Numerous metabolic dysfunctions are related to insulin-mediated altered glucose homeostasis. One of the significant pathophysiological conditions linked to the insulin associated disorder is diabetes mellitus (DM) (type 1, type 2, and gestational). Insulin resistance (IR) is one of the major underlying causes of metabolic disorders despite its association with several physiological conditions. Metabolic syndrome (MS) is another pathophysiological condition that is associated with IR, hypertension, and obesity. Further, several other pathophysiological disorders/diseases are associated with the insulin malfunctioning, which include polycystic ovary syndrome, neuronal disorders, and cancer. Insulinomas are an uncommon type of pancreatic β-cell-derived neuroendocrine tumor that makes up 2% of all pancreatic neoplasms. Literature revealed that different biochemical events, molecular signaling pathways, microRNAs, and microbiota act as connecting links between insulin disorder and associated pathophysiology such as DM, insuloma, neurological disorder, MS, and cancer. In this review, we focus on the insulin-related disorders and the underlying mechanisms associated with the pathophysiology.

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Section: Discussionmentioning

confidence: 99%

Diagnosis and treatment of Whipple disease after kidney transplantation: A case report

Chen,

Niu,

Zhang

2023

World J Clin Cases

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“… 2 Some patients may exhibit chronic infections, including endocarditis, encephalitis, arthritis, lymphnoditis, and uveitis. The disease may also manifest as asymptomatic carriage or acute infections, 3 , 4 such as gastroenteritis, pneumonia, and bacteremia. Lagier et al found in their study conducted between 2006 and 2014 that 65 (37.1%) out of 175 patients with acute TW infection presented with pneumonia.…”

Section: Introductionmentioning

confidence: 99%

Clinical, Laboratory, and Imaging Characteristics of Tropheryma Whipplei Detection in Bronchoalveolar Lavage Fluid Using Next-Generation Sequencing: A Case-Control Study

Shen,

Cui,

Teng

et al. 2024

IDR

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Objective The aim of this study was to assess the prevalence of Tropheryma whipplei (TW) infection in the population and to investigate the clinical symptoms, as well as the laboratory and imaging characteristics of patients testing positive for TW using next-generation sequencing (NGS). Methods A retrospective review was conducted on 1346 bronchoalveolar lavage fluid (BALF) samples collected between January 2021 and September 2023. The case group comprised patients with TW detected using NGS while the control group included 65 randomly chosen Gram-positive bacterial infection patients without TW. Comparative analyses were carried out on the basic demographics, laboratory parameters, and imaging findings between the two groups. Additionally, the case group underwent an in-depth examination of underlying diseases, pathogens, final diagnoses, treatment strategies. Results The case group comprised of 51 patients with TW, constituting 3.8% of the total. There was no significant difference in gender and age between the case and control groups ( P = 0.84, P = 0.07 ). Symptoms such as coughing, expectoration, wheezing, fever, and hemoptysis are less commonly detected in the case group with a higher incidence of chest pain when compared to the control group ( P >0.05). The case group exhibited decreased albumin levels and increased C-reactive protein and D-dimer levels compared to normal levels. Imaging findings in the case group commonly included nodules, patchy images, and interstitial changes, the most common underlying disease is cardiovascular disease, and the most frequently co-occurring pathogen is the human herpesvirus. Among the case group, 27 patients received a final diagnosis of pneumonia, and 3 patients clinically diagnosed with Whipple’s disease demonstrated improvement in both symptoms and imaging after treatment. Conclusion NGS revealed a relatively low overall detection rate of TW-positive patients using BALF. TW was more prevalent in middle-aged and elderly male patients characterized by symptoms such as cough, expectoration, shortness of breath, and fever. Chest imaging in these cases typically showed nodules and interstitial changes.

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Whipple’s Disease Endocarditis Following Immunomodulatory Treatment for Arthritis: A Case Report and Screening Recommendation

Back,

Meade,

Arif

et al. 2024

Cureus

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Whipple's disease (WD) is a rare systemic disorder affecting various organ systems, including the gastrointestinal, cardiovascular, and joint systems. This report discusses a case of WD endocarditis likely associated with tocilizumab (TCZ), an immunomodulator used to treat refractory seronegative arthritis, in a patient with coronary artery disease and rheumatoid arthritis. The diagnosis was confirmed through laboratory studies, imaging, and esophagogastroduodenoscopy with biopsies. WD is increasingly recognized as a potential etiology of seronegative arthritis, with joint pain often preceding gastrointestinal symptoms. Immunomodulatory agents such as TCZ, while effective for rheumatoid arthritis, may exacerbate underlying WD, potentially leading to severe complications such as endocarditis. This case reveals the importance of considering WD in patients with refractory arthritis and the necessity of thorough diagnostic evaluation before initiating immunomodulatory therapy. Epidemiological studies indicate a higher prevalence of WD in certain demographics, highlighting the need for targeted screening with noninvasive screening methodologies, such as stool and saliva polymerase chain reaction testing.

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Whipple’s disease-associated infective endocarditis: a systematic review

Cited by 3 publications

References 109 publications

Diagnosis and treatment of Whipple disease after kidney transplantation: A case report

Diagnosis and treatment of Whipple disease after kidney transplantation: A case report

Clinical, Laboratory, and Imaging Characteristics of Tropheryma Whipplei Detection in Bronchoalveolar Lavage Fluid Using Next-Generation Sequencing: A Case-Control Study

Whipple’s Disease Endocarditis Following Immunomodulatory Treatment for Arthritis: A Case Report and Screening Recommendation

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