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Case Reports: Rare disease
Whipple’s disease unmasked by TNF inhibitor therapy for treatment of seronegative rheumatoid arthritis
  1. Fahad Mohammed1,
  2. Muhannad Kurtom2,
  3. Andrew Brant3 and
  4. Rahul Sampath4
  1. 1Neuroscience, Duke University Trinity College of Arts and Sciences, Durham, North Carolina, USA
  2. 2Medicine, UNC Health Blue Ridge, Morganton, North Carolina, USA
  3. 3Pathology, UNC Health Blue Ridge, Morganton, North Carolina, USA
  4. 4Infectious Disease, UNC Health Blue Ridge, Morganton, North Carolina, USA
  1. Correspondence to Fahad Mohammed; fsm10{at}duke.edu

Abstract

We report a patient with seronegative rheumatoid arthritis diagnosed with Whipple’s disease following treatment of tumour necrosis factor inhibitor (TNFI) therapy. Whipple’s disease should be considered in patients with seronegative rheumatoid arthritis and other unexplained multisystem illness. The TNFI therapy and immunosuppressive therapies can unmask latent Whipple’s disease.

  • Infection (gastroenterology)
  • Hepatitis and other GI infections

https://doi.org/10.1136/bcr-2022-250693

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    Footnotes

    • Contributors FM: planning the report, interpreting the data and drafting the manuscript. Approved the final draft submitted. MK: planning the report, interpreting the data and drafting the manuscript. Approved the final draft submitted. AB: planning the report, collecting and interpreting the data and drafting the manuscript. Involved in analysing the histopathology slides. Approved the final draft submitted. RS: planning the report, collecting and interpreting the data and drafting the manuscript. Provided care for the patient. Approved the final draft submitted.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.