Whipple disease mimicking adult-onset Still's disease and treated by anakinra: Diagnosis using PCR

摘要

Whipple's disease (WD) is a rare, chronic, systemic infection due to Tropheryma whipplei (1, 2). The diagnosis is challenging, which explains why some patients mistakenly thought to have inflammatory joint disorders have received inappropriate biological therapy (1, 3). Real-time polymerase chain reaction (PCR) assays targeting different sequences of the T. whipplei genome have been useful in diagnosis (4). Here, we report on a patient with polyarthritis and skin lesions who received a misdiagnosis of adult-onset Still's disease and in whom WD was finally diagnosed by the results of PCR assays of skin biopsy specimens. Before specific antibidherapy, treatment with anakinra markedly improved all symptoms, which suggests a role for interleukin (IL)-1beta in some clinical features of the disease.