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Case Reports
. 2022 Jul 21;15(7):e250693.
doi: 10.1136/bcr-2022-250693.

Whipple's disease unmasked by TNF inhibitor therapy for treatment of seronegative rheumatoid arthritis

Fahad Mohammed  1 , Muhannad Kurtom  2 , Andrew Brant  3 , Rahul Sampath  4
Affiliations
Case Reports

Whipple's disease unmasked by TNF inhibitor therapy for treatment of seronegative rheumatoid arthritis

Fahad Mohammed et al. BMJ Case Rep. .

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.

Keywords: Hepatitis and other GI infections; Infection (gastroenterology).

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Villi filled and expanded by pale histiocytes.
Figure 2
Figure 2
Periodic acid-Schiff demonstrating coarse granularity of organisms within histiocytes.
Figure 3
Figure 3
High-power view showing coarse granular staining of organisms within histiocytes with periodic acid-Schiff stain.
See this image and copyright information in PMC

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